New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/14/2025 11:59:00 AM
Cost:
100
Service:
Frame + Lenses
prescribed by doctor:
dr. HassaN
Notes:
AR cylinder transition 1.61
SPH
CYL
AX
ADD
OD
-5.5
-1
40
OS
-5.5
-1.5
150
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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