New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/6/2026 4:54:00 PM
Cost:
100
Service:
Frame + Lenses
prescribed by doctor:
Dr. Ali Alhaj
Notes:
Antiblue compacted
SPH
CYL
AX
ADD
OD
3.25
-4
5
OS
3.5
-4.5
165
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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