New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/14/2024 11:58:00 AM
Cost:
30
Service:
Change Lenses
prescribed by doctor:
Dr. Hussien Hazimeh
Notes:
Transition AR
SPH
CYL
AX
ADD
OD
0
OS
-1
-0.75
95
Date of visit:
6/25/2024 6:11:00 PM
Cost:
25
Service:
Frame + Lenses
prescribed by doctor:
Dr. Hussein Hazmieh
Notes:
For Near Only
SPH
CYL
AX
ADD
OD
2.75
OS
1.75
-0.75
95
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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