New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/8/2025 3:14:00 PM
Cost:: 250
Service:: Frame + Lenses
prescribed by doctor:: Dr.Bassam Barakat
Notes:: SWING FRAME + AR 1.74 Lenses

	SPH	CYL	AX	ADD
OD	-6
OS	-7

Date of visit:: 1/8/2026 4:47:00 PM
Cost:: 500
Service:: Frame+Lenses
prescribed by doctor:: dr. Jamal bleik
Notes:: new frame , myopia control rodenstock 1.67

	SPH	CYL	AX	ADD
OD	-9	1.5	100
OS	-10	1	60

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS