New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/15/2025 11:18:00 AM
Cost:
30
Service:
Frame + Lenses
prescribed by doctor:
Dr. Hassan Salam
Notes:
volocino , AR
SPH
CYL
AX
ADD
OD
-0.75
-1
85
OS
0.5
-1.75
55
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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