New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/18/2024 11:19:00 AM
Cost:
70
Service:
Frame + Lenses
prescribed by doctor:
Dr. Hassan Chahine
Notes:
Gucci Frame +AR TRANSITION Lenses (Metal)
SPH
CYL
AX
ADD
OD
1.25
1
5
OS
-0.25
1.25
130
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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