New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/23/2024 11:20:00 AM
Cost:
20
Service:
Change Lenses
prescribed by doctor:
Old RX
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
0.25
-0.75
50
OS
-1.5
68
Date of visit:
2/3/2025 10:54:00 AM
Cost:
70
Service:
2Frame+Lenses
prescribed by doctor:
dr. salah aladki
Notes:
AR Lenses one for far and one for near for far 40dollar for near be 30
SPH
CYL
AX
ADD
OD
-0.5
1
170
1.75
OS
-1.5
1.5
160
1.74
Date of visit:
2/3/2025 4:05:00 PM
Cost:
195
Service:
Frame + Lenses
prescribed by doctor:
dr. salah aladki
Notes:
Airlite, progressive infinity AR
SPH
CYL
AX
ADD
OD
-0.5
1
170
1.75
OS
-1.5
1.5
160
1.75
Date of visit:
4/9/2025 11:29:00 AM
Cost:
0
Service:
Frame+Lenses
prescribed by doctor:
dr. salah aladki
Notes:
AR
SPH
CYL
AX
ADD
OD
-0.5
1
170
OS
-1.5
1.5
160
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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