New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/6/2024 11:15:00 AM
Cost:
70
Service:
Frame+lenses Ar compact
prescribed by doctor:
Dr. MOUSA
Notes:
SPH
CYL
AX
ADD
OD
-3.25
-2.25
20
OS
-2.5
-2.5
160
Date of visit:
6/15/2026 11:36:00 AM
Cost:
50
Service:
Change Lenses
prescribed by doctor:
Dr. Hasan Chahine
Notes:
AR 1.67
SPH
CYL
AX
ADD
OD
-5.75
2.25
115
OS
-5.5
2.5
70
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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