New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/8/2024 4:41:00 PM
Cost:
150
Service:
Frame + Progressive Lenses
prescribed by doctor:
Dr. Jamal Haidar
Notes:
Frame + Infinity + FMC
SPH
CYL
AX
ADD
OD
2
-0.75
45
2.5
OS
1.5
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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