New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 4/8/2025 11:49:00 AM
Cost:
Service:: Frame + Lenses
prescribed by doctor:: Nancy
Notes:: AR

	SPH	CYL	AX	ADD
OD	0.25	-1.75	90
OS	1.5	-1.5	113

Date of visit:: 4/5/2025 4:36:00 PM
Cost:: 80
Service:: Frame+Lenses
prescribed by doctor:: Dr. Ali Alhakim
Notes:: AR FOR DISTANCE

	SPH	CYL	AX	ADD
OD		-2.5	95
OS		1.5	180

Date of visit:: 4/5/2025 4:36:00 PM
Cost:: 80
Service:: Frame+Lenses
prescribed by doctor:: Dr. Ali Alhakim
Notes:: AR FOR DISTANCE

	SPH	CYL	AX	ADD
OD		-2.5	95
OS		1.5	180

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS