New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/9/2024 1:25:00 PM
Cost:: 150
Service:: Frame + Lenses
prescribed by doctor:: Aya
Notes:: Airlite + AR Lenses Transtion

	SPH	CYL	AX	ADD
OD	-2.5
OS	-1

Date of visit:: 2/15/2025 3:36:00 PM
Cost:: 70
Service:: change lenses
prescribed by doctor:: Dr. Ali Alhakim
Notes:: AR 1.67

	SPH	CYL	AX	ADD
OD	-4.5
OS	-4.5

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS