New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 1/24/2025 11:03:00 AM
Cost:: 40
Service:: Frame + Lenses
prescribed by doctor:: Dr. Mustapha Daher
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	-2.25
OS	-2.5

Date of visit:: 5/1/2025 5:13:00 PM
Cost:: 15
Service:: change lenses
prescribed by doctor:: dr. Mustapha Daher
Notes:: AR

	SPH	CYL	AX	ADD
OD	-3
OS	-2.75

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS