New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/8/2024 12:20:00 PM
Cost:
40
Service:
Change Lenses
prescribed by doctor:
Dr. Mohamad Assaf
Notes:
Compact AR
SPH
CYL
AX
ADD
OD
-4.25
-1.25
180
OS
-5.5
-1.75
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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