New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/20/2026 10:40:00 AM
Cost:
110
Service:
Frame + Lenses
prescribed by doctor:
Dr. Issam Hmedeh
Notes:
Transition AR W9
SPH
CYL
AX
ADD
OD
-0.75
-2
30
OS
-0.75
-0.75
140
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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