New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/27/2025 3:50:00 PM
Cost:
180
Service:
Frame + Lenses
prescribed by doctor:
dr.moussa cheib
Notes:
AR , progressive pravious top
SPH
CYL
AX
ADD
OD
1.75
0.25
40
2.75
OS
1.75
0.25
120
2.75
Date of visit:
3/12/2025 3:58:00 PM
Cost:
90
Service:
change lenses
prescribed by doctor:
dr. moussa cheib
Notes:
progressive pravious Top AR Idol
SPH
CYL
AX
ADD
OD
1.75
0.25
40
2.75
OS
1.75
0.25
120
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
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