New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/28/2025 11:52:00 AM
Cost:
100
Service:
frame+lenses
prescribed by doctor:
Dr. Randa Haddad
Notes:
Frame+ Antiblue green coated
SPH
CYL
AX
ADD
OD
-0.5
-0.5
135
OS
-0.5
-0.25
50
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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