New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/21/2024 5:19:00 PM
Cost:: 70
Service:: Frame + Lenses
prescribed by doctor:: Dr. Hussein Alame
Notes:: NLP IN OD

	SPH	CYL	AX	ADD
OD	0	0	0
OS	0.5	-3	90

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS