New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/8/2025 4:26:00 PM
Cost:
200
Service:
Frame + Lenses
prescribed by doctor:
Dr. Ali Shokor
Notes:
plastic frame progressive infinity AR + MONTAGE
SPH
CYL
AX
ADD
OD
0.75
-0.5
110
2.5
OS
1
-0.25
180
2.5
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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