New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 8/30/2025 5:21:00 PM
Cost:: 35
Service:: Frame + Lenses
prescribed by doctor:: Dr. Abass Baydoun
Notes:: Antiblue blue coated

	SPH	CYL	AX	ADD
OD	1.25
OS	1.25

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS