New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/19/2024 6:15:00 PM
Cost:
50
Service:
Change Lenses
prescribed by doctor:
Dr. Mahmmoud Jaroudi
Notes:
Compact AR
SPH
CYL
AX
ADD
OD
-5.25
4.25
75
OS
-4.25
3
100
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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