New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
12/24/2025 5:51:00 PM
Cost:
10
Service:
Change 1 Lens ONLY
prescribed by doctor:
Dr. Abbass Baydoun
Notes:
CHANGE OD ONLY
SPH
CYL
AX
ADD
OD
1
-2.5
20
OS
0.5
-0.5
160
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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