New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/10/2024 6:44:00 PM
Cost:: 50
Service:: Frame airlite + AR
prescribed by doctor:: Dr. Moustafa Daher
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	5	-1.5	10
OS	4.5	-0.25	160

Date of visit:: 12/6/2024 5:31:00 PM
Cost:: 35
Service:: change Lenses
prescribed by doctor:: Dr. Mostafa Daher
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	4	1.5	95
OS	4	0.75	80

Date of visit:: 6/16/2025 12:31:00 PM
Cost:: 50
Service:: Frame+Lenses
prescribed by doctor:: dr. Mustapha Daher
Notes:: AR

	SPH	CYL	AX	ADD
OD	5.5	-1.5	7
OS	5	-0.5	4

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS