New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/14/2025 12:41:00 PM
Cost:
90
Service:
change lenses
prescribed by doctor:
Dr.Khalil Chahine
Notes:
AR 1.61 ONE FOR FAR ONE NEAR(4.75+0.5x75, 5.25+0.5x170)
SPH
CYL
AX
ADD
OD
3.25
0.5
75
OS
3.75
0.5
170
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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