New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/19/2025 3:20:00 PM
Cost:
395
Service:
Frame + Lenses + Change lenses
prescribed by doctor:
Dr. Yehya Chahine
Notes:
Carrera Frame + 1.74 lenses and Oliver peoples black + 1.75 lenses
SPH
CYL
AX
ADD
OD
-7
-0.5
160
OS
-6.75
-1.25
165
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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