New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 2/21/2024 11:33:00 AM
Cost:: 50
Service:: frame + ar modern
prescribed by doctor:: aya
Notes:

	SPH	CYL	AX	ADD
OD	1	-1.5	90
OS	-1.5	-1	80

Date of visit:: 4/23/2024 2:15:00 PM
Cost:: 0
Service:: Contact Lenses
prescribed by doctor:: Dr. Ali Ahmad
Notes:

	SPH	CYL	AX	ADD
OD	0.5	-2.25	95
OS	-1.75	-2.25	95

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS