New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
Cost:
25
Service:
frame + lenses of reading only
prescribed by doctor:
hasan salam
Notes:
she didn't adapt on doctor prescription
SPH
CYL
AX
ADD
OD
1.75
2
OS
1.5
2
Date of visit:
2/28/2024 11:26:00 AM
Cost:
8
Service:
change lenses for near
prescribed by doctor:
old frame
Notes:
SPH
CYL
AX
ADD
OD
2
OS
2
Date of visit:
11/18/2025 2:13:00 PM
Cost:
120
Service:
Change Lenses
prescribed by doctor:
DR. Ali Alhaj
Notes:
Freeform AR
SPH
CYL
AX
ADD
OD
2.25
1.75
OS
2
1.75
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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