New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/24/2025 2:13:00 PM
Cost:: 250
Service:: Frame + Lenses
prescribed by doctor:: Dr. hassanin Assaf
Notes:: Progressive AR pravious top AR TRANSITION +MONTAGE

	SPH	CYL	AX	ADD
OD	0	-0.75	80	1.25
OS	0	-1	90	1.25

Date of visit:: 5/19/2025 2:09:00 PM
Cost:: 0
Service:: change lenses
prescribed by doctor:: Dr. Hassanin Assaf
Notes:: AR

	SPH	CYL	AX	ADD
OD	1.25	-0.75	80
OS	1.25	-1	90

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS