New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
9/18/2025 3:38:00 PM
Cost:
65
Service:
Frame + Lenses
prescribed by doctor:
Dr. Ali Hakim
Notes:
Fraeis Gatte Frame + AR Lenses , yes one eye is - and one is +
SPH
CYL
AX
ADD
OD
-0.75
90
OS
0.75
175
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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