New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/2/2024 3:35:00 PM
Cost:
110
Service:
Change lenses
prescribed by doctor:
Dr. Issam Hamadeh
Notes:
AR + Transition
SPH
CYL
AX
ADD
OD
2.5
0.5
70
OS
2.5
0.5
100
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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