New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
12/29/2023 2:32:00 PM
Cost:
250
Service:
Frame + Lenses
prescribed by doctor:
Dr. Salah Ladki
Notes:
Progressive US Design AR Transtion + Montage Idol
SPH
CYL
AX
ADD
OD
-0.75
0.75
180
1.5
OS
-0.75
0.75
10
1.5
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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