New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/10/2025 4:55:00 PM
Cost:
100
Service:
Frame + Lenses
prescribed by doctor:
Dr. Mohammad Khalifeh
Notes:
Plastic frame +antiblue
SPH
CYL
AX
ADD
OD
-2.5
-1.75
175
OS
-1.75
-1.75
170
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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