New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/10/2024 5:58:00 PM
Cost:
150
Service:
Frame + Lenses
prescribed by doctor:
Aya
Notes:
US-Design FMC Transition + Montage
SPH
CYL
AX
ADD
OD
0.75
-0.75
77
2.25
OS
-1
160
2.25
Date of visit:
1/14/2025 2:40:00 PM
Cost:
160
Service:
Frame+Lenses
prescribed by doctor:
DR. Ali Alhaj
Notes:
Oga Spirit frame ,infinity transition idol cut
SPH
CYL
AX
ADD
OD
0
1.25
160
2.25
OS
0
-1
175
2.25
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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