New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/3/2024 6:46:00 PM
Cost:
130
Service:
Frame + Progressive Lenses
prescribed by doctor:
Dr. Ali Abed Hussein Hajj
Notes:
U.S Design FMC
SPH
CYL
AX
ADD
OD
-3.75
2.25
OS
-3.75
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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