New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/11/2024 1:43:00 PM
Cost:: 40
Service:: Airlite
prescribed by doctor:: Hussein Hazimeh
Notes:: AR

	SPH	CYL	AX	ADD
OD	1.5	-4	5
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