New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
10/8/2025 4:44:00 PM
Cost:
140
Service:
2Frame +2 Lenses
prescribed by doctor:
Dr. Jamal Haidar
Notes:
AR, FOR BOTH AZ FOR NEAR +PLASTIC FRAME FPR FAR
SPH
CYL
AX
ADD
OD
0.25
1.75
OS
1
1.75
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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