New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
12/23/2024 2:33:00 PM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
dr. hussein Alameh
Notes:
AR
SPH
CYL
AX
ADD
OD
3.5
OS
4
-1.5
100
Date of visit:
12/23/2024 2:36:00 PM
Cost:
60
Service:
Frame+Lenses
prescribed by doctor:
Nancy
Notes:
AR Lenses = plastic frame for far
SPH
CYL
AX
ADD
OD
1.5
OS
1.75
-1.5
100
Date of visit:
12/28/2024 4:43:00 PM
Cost:
385
Service:
Frame + Lenses
prescribed by doctor:
Dr.Hussein Alameh
Notes:
Progressive Synchrony AR Transition + Airlite @IDOL
SPH
CYL
AX
ADD
OD
1.5
2.25
OS
2.25
-1.25
95
2.25
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
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