New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/25/2024 10:04:00 AM
Cost:
15
Service:
Change Lenses
prescribed by doctor:
Dr. Ali Mhamoud Al Haj
Notes:
AR Lenses for Reading
SPH
CYL
AX
ADD
OD
2
-1.25
80
1.5
OS
1
-2.25
90
1.5
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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