New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/11/2024 4:15:00 PM
Cost:
130
Service:
2 Frames + 2 Lenses (Airlite)
prescribed by doctor:
Dr. Salah El Ladki
Notes:
AR Transition for Far + AR 60mm for near
SPH
CYL
AX
ADD
OD
1.25
0.5
30
2.5
OS
1.5
0.5
130
2.5
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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