New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/28/2024 4:27:00 PM
Cost:
160
Service:
Change Lenses
prescribed by doctor:
Dr. Nabih Chamas
Notes:
U.S desgin FMC + TRANSITION + MONATGE IDOL
SPH
CYL
AX
ADD
OD
0.75
0.75
2
2.5
OS
0.25
1
180
2.5
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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