New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/15/2025 10:43:00 AM
Cost:
45
Service:
Change Lenses
prescribed by doctor:
Dr. Alaa Bou Ghanam
Notes:
2 pairs of change lenses , AR transition for far and AR for near
SPH
CYL
AX
ADD
OD
-1
0.25
165
OS
-1
0.5
135
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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