New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/15/2025 12:46:00 PM
Cost:
60
Service:
Change Lenses
prescribed by doctor:
Dr. Osama Jebaii
Notes:
ANTIBLUE TRANSITION
SPH
CYL
AX
ADD
OD
-1
-0.5
105
OS
0
-1.75
170
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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