New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/11/2026 5:03:00 PM
Cost:
30
Service:
Frame + Lenses
prescribed by doctor:
Dr. Ali Alhaj
Notes:
AR
SPH
CYL
AX
ADD
OD
-1
-0.75
10
OS
-1
-0.5
170
Date of visit:
2/11/2026 5:09:00 PM
Cost:
16
Service:
Contact Lenses +solution
prescribed by doctor:
nancy
Notes:
clear 55
SPH
CYL
AX
ADD
OD
-1.25
OS
-1.25
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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