New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/3/2025 1:26:00 PM
Cost:
70
Service:
2 Frame + 2 Lenses
prescribed by doctor:
Dr. Ali Hakim
Notes:
Airlite Frame + Metal frame 1 for dist and 1 for Near
SPH
CYL
AX
ADD
OD
-0.75
35
2.25
OS
-1.5
65
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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