New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/23/2025 1:54:00 PM
Cost:
120
Service:
Frame + Lenses
prescribed by doctor:
Dr. Hassan Chahine
Notes:
gusto frame 1.67 AR
SPH
CYL
AX
ADD
OD
5.5
1.5
10
OS
6.5
0.75
180
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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