New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/18/2025 2:38:00 PM
Cost:
110
Service:
Frame + Lenses + Change lenses
prescribed by doctor:
Dr. Hassan Salam
Notes:
Airlite + AR Lenses + Pair AR
SPH
CYL
AX
ADD
OD
2.5
OS
2
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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