New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/8/2025 11:54:00 AM
Cost:
20
Service:
change lenses AR
prescribed by doctor:
Dr. Ali Alhaj
Notes:
AR
SPH
CYL
AX
ADD
OD
2.25
OS
1.5
0.75
10
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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