New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
10/24/2025 5:46:00 PM
Cost:
130
Service:
2 Frames + 2 Pairs of Lenses
prescribed by doctor:
Dr. Mounir Kassir
Notes:
AR For Both
SPH
CYL
AX
ADD
OD
1.75
-1.75
10
2.5
OS
-1
5
2.5
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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