New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 10/22/2025 12:24:00 PM
Cost:: 50
Service:: Change Lenses
prescribed by doctor:: Dr. Hassan Chahine
Notes:: AR Transition W9

	SPH	CYL	AX	ADD
OD	-0.5	0.25	175
OS	-1.25	0.25	45

Date of visit:: 2/17/2026 3:31:00 PM
Cost:: 20
Service:: change lenses
prescribed by doctor:: dr. hassan chahine
Notes:: old frame AR FOR NEAR

	SPH	CYL	AX	ADD
OD	2	0.25	175
OS	1.25	0.25	45

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS