New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
10/29/2025 1:33:00 PM
Cost:
120
Service:
Change Lenses
prescribed by doctor:
Dr. Hassan Chahine
Notes:
Progressive infinity pro + montage
SPH
CYL
AX
ADD
OD
-2.25
2.5
5
OS
-2.5
2.5
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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