New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 1/14/2025 10:56:00 AM
Cost:: 25
Service:: Change Lenses
prescribed by doctor:: Dr Ali hakeem
Notes:: old frame , AR LENSES

	SPH	CYL	AX	ADD
OD	1.25	-0.5	180
OS	1.25	-1.25	180

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS