New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/30/2024 3:18:00 PM
Cost:: 65
Service:: Frame + Lenses
prescribed by doctor:: Dr. Ali Abass Shokor
Notes:: Compact 50mm AR

	SPH	CYL	AX	ADD
OD	5.25	-1.5	180
OS	5.25	-2	165

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS