New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 12/24/2024 4:33:00 PM
Cost:: 20
Service:: Metal Frame
prescribed by doctor:: Dr. Hussein Alameh
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	-0.25
OS		-0.25	180

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS