New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/17/2024 5:05:00 PM
Cost:
30
Service:
Frame + Lenses
prescribed by doctor:
Old RX
Notes:
AR Lenses for near
SPH
CYL
AX
ADD
OD
2
OS
2
Date of visit:
2/15/2025 2:55:00 PM
Cost:
50
Service:
2frames +lenses
prescribed by doctor:
dr. Rola Hattom
Notes:
AR Lenses +TRANSITION W9 FOR FAR , for near old frame lenses for free and only AR
SPH
CYL
AX
ADD
OD
1
1.5
OS
1
1.5
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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