New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/21/2024 5:16:00 PM
Cost:: 20
Service:: Change lenses AR
prescribed by doctor:: Dr. Moustafa Daher
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	0	-1.25	90
OS	0	-1	85

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS