New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/9/2025 7:03:00 PM
Cost:: 70
Service:: Frame + Lenses
prescribed by doctor:: Dr.Hussein Alameh
Notes:: Frame Metal + AR Lenses

	SPH	CYL	AX	ADD
OD	-6.5	-0.75	100
OS	-6.25	-0.25	80

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS