New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/15/2024 11:53:00 AM
Cost:
70
Service:
Frame + Lenses
prescribed by doctor:
Notes:
AR Lenses 60 mm
SPH
CYL
AX
ADD
OD
3.5
1
90
OS
3
Date of visit:
8/8/2024 5:25:00 PM
Cost:
35
Service:
change lenses
prescribed by doctor:
Dr. Ali Abed Al Hajj
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
3.5
1
90
OS
2.5
0.5
90
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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