New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 2/9/2025 10:49:00 AM
Cost:: 110
Service:: Frame + Lenses
prescribed by doctor:: Dr. Mustapha Daher
Notes:: plastic glasses with sketch , Bifocal lenses AR cut by hassan

	SPH	CYL	AX	ADD
OD	1.75	-0.75	20	1.75
OS	1.75	-0.75	150	1.75

Date of visit:: 2/15/2025 3:06:00 PM
Cost:: 40
Service:: Frame+Lenses
prescribed by doctor:: dr. Mustapha Daher
Notes:: michael korse , AR FOR NEAR

	SPH	CYL	AX	ADD
OD	1.75	-0.75	20	1.75
OS	1.75	-0.75	150	1.75

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS