New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/18/2025 2:03:00 PM
Cost:
90
Service:
Frame + Lenses+
prescribed by doctor:
Dr. Ziad khoueir
Notes:
Levist olive , AR for far + AR compact for near
SPH
CYL
AX
ADD
OD
1
0.5
155
2.5
OS
1
0.5
165
2.5
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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