New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/13/2026 2:59:00 PM
Cost:
90
Service:
Frame + Lenses + change lenses
prescribed by doctor:
dr. Mustapha Daher
Notes:
AR for near 30dollar + 60 dollar frame +lenses
SPH
CYL
AX
ADD
OD
1.75
-0.5
70
1.75
OS
1.75
-0.75
77
1.75
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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