New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/15/2025 2:23:00 PM
Cost:: 60
Service:: 60
prescribed by doctor:: Dr. Ali Alhaj
Notes:: Airlite, AR

	SPH	CYL	AX	ADD
OD	-2	-0.75	160
OS	-2.25	-0.25	20

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS