New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/10/2025 11:19:00 AM
Cost:
50
Service:
Change Lenses
prescribed by doctor:
Dr. Ali Alhaj
Notes:
AR + transition W9
SPH
CYL
AX
ADD
OD
0.25
-0.75
95
OS
0.5
-1.25
75
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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