New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 6/25/2024 6:26:00 PM
Cost:: 200
Service:: Frame + Lenses
prescribed by doctor:: Aya
Notes:: infinity FMC transition + Monatge

	SPH	CYL	AX	ADD
OD	1.25	-0.75	60
OS		-0.5	160

Date of visit:: 7/13/2024 6:12:00 PM
Cost:: 0
Service:: change lenses
prescribed by doctor:: Dr. Sabrina Rammal
Notes:: infinity FMC TRANSITION (PD=62.5)

	SPH	CYL	AX	ADD
OD	2.5	-1.25	40	2.5
OS		-1	165	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