New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 2/18/2025 12:06:00 PM
Cost:: 80
Service:: Frame + Lenses
prescribed by doctor:: Dr. Mustapha Daher
Notes:: Airlite + AR Lenses

	SPH	CYL	AX	ADD
OD	3.25	-4.5	5
OS	3.25	-4.5	175

Date of visit:: 9/19/2025 4:56:00 PM
Cost:: 50
Service:: Frame Only
prescribed by doctor:
Notes:: Oliver people transparent frame

	SPH	CYL	AX	ADD
OD
OS

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS