New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/9/2024 6:41:00 PM
Cost:
95
Service:
1 Frame + Lenses and 1 Change Trans Lenses
prescribed by doctor:
Dr. Mohammad Assaf
Notes:
AR + Transition for Distance and AR Lenses for Near
SPH
CYL
AX
ADD
OD
0
2.25
OS
1
-1
65
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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