New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
12/31/2025 2:26:00 PM
Cost:
220
Service:
Frame + Lenses
prescribed by doctor:
Dr. Hassan Chahine
Notes:
Fila Semi Rimless + Laser Red IDOL
SPH
CYL
AX
ADD
OD
1.25
1.5
150
OS
1.5
1
30
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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