New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/8/2025 2:01:00 PM
Cost:
40
Service:
Change Lenses 2 Pairs
prescribed by doctor:
Dr. Jamal Haidar
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
0.75
-1.25
90
2
OS
0.25
2
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
Back to List