New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/16/2024 3:57:00 PM
Cost:
100
Service:
Frame + Lenses
prescribed by doctor:
Dr.Hussien Hazimeh
Notes:
Metal Frame+Infinity white
SPH
CYL
AX
ADD
OD
1.25
-0.5
65
2.5
OS
1.25
-0.5
120
2.5
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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