New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/22/2024 2:19:00 PM
Cost:: 35
Service:: Frame + Transtion Lenses AR
prescribed by doctor:: Dr. Ali Reda Haj Hassan
Notes:: He took this frame depending on sale 50% mothers day post

	SPH	CYL	AX	ADD
OD	0.5	-0.5	165
OS	0.25	-2	10

Date of visit:: 5/31/2024 3:03:00 PM
Cost:: 40
Service:: Frame + Lenses
prescribed by doctor:: Old Rx
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	0.5	-0.5	165
OS	0.25	-2	10

Date of visit:: 12/2/2024 2:54:00 PM
Cost:: 70
Service:: Frame+Lenses
prescribed by doctor:: Nancy
Notes:: Transition AR

	SPH	CYL	AX	ADD
OD	0.25	-0.75	170
OS	0.25	-2.5	10

Date of visit:: 3/7/2025 1:58:00 PM
Cost:: 40
Service:: change lenses
prescribed by doctor:: Dr. Sabrina Rammal
Notes:: AR Transition

	SPH	CYL	AX	ADD
OD	0.75	-0.75	160
OS	1.25	-3	10

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS