PATIENT RECORD
Time of appointment: 10:00 am
Given names: Simon
Family name: Lee
Date of birth: , 1989
Address: Adams Terrace, Wellington
Phone number: 0211558809
Name of insurance company: “for life”
Date of last eye test:
Patient’s observations: Problems seeing
Simon must wear his glasses when
The least expensive type of glasses is
The glasses Simon chooses are nice and
Simon decides to pay by