New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/8/2024 4:54:00 PM
Cost:
95
Service:
2 Frame + 2 Lenses
prescribed by doctor:
Dr. Ali Hakim
Notes:
Transition AR for Far + AR for Near
SPH
CYL
AX
ADD
OD
0.5
0.5
90
2
OS
0.5
2
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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