New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/31/2025 12:51:00 PM
Cost:
70
Service:
frame+lenses
prescribed by doctor:
Dr. Ali Alhakim
Notes:
AR THE AXIS FOR LEFT EYE IS NOT WRITTEN (LUNA)
SPH
CYL
AX
ADD
OD
4.5
1.5
100
OS
5.5
1.5
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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