New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/6/2024 3:41:00 PM
Cost:
250
Service:
Frame + Lenses
prescribed by doctor:
Dr. Mohammad Assaf
Notes:
U.S Design FMC+Montage
SPH
CYL
AX
ADD
OD
0
1
15
OS
0.25
-0.75
70
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
Back to List