New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/2/2024 1:57:00 PM
Cost:
85
Service:
frame + Transtion lenses ar
prescribed by doctor:
Dr. Mustapha Daher
Notes:
FLEX + LENSES W9
SPH
CYL
AX
ADD
OD
2.75
-1.5
15
OS
2.5
-0.5
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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