New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/14/2025 11:11:00 AM
Cost:
50
Service:
Frame + Lenses
prescribed by doctor:
Dr. Moussa Shoueib
Notes:
AR
SPH
CYL
AX
ADD
OD
-3
-1
180
OS
-4
-0.5
175
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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