New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 4/19/2025 12:25:00 PM
Cost:: 55
Service:: Frame + Lenses
prescribed by doctor:: Dr. Ali Alhaj
Notes:: Metalic frame , AR

	SPH	CYL	AX	ADD
OD	-1.25	-1.25	165
OS	-1	-1.75	25

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS