Allāhumma `āfinī fī badanī,
Allāhumma `āfinī fī sam`ī,
Allāhumma `āfinī fī baṣarī,
lā ilāha illā ant.
Allāhumma innī a`ūdhu bika mina ‘l-kufri, wa ‘l-faqr,
wa a`ūdhu bika min `adhābi ‘l-qabr,
lā ilāha illā ant.
O Allah, make me healthy in my body.
O Allah, preserve for me my hearing.
O Allah, preserve for me my sight.
There is none worthy of worship but You.
O Allah, I seek refuge in You from disbelief and poverty,
and I seek refuge in You from the punishment of the grave.
There is none worthy of worship but You
(Recite three times in Arabic.)
Reference:
Abu Dawud 4/324, Ahmad 5/42, An-Nasa'i, 'Amalul-Yawm wal-Laylah (no. 22),
Ibn As-Sunni (no. 69), Al-Bukhari Al-'Adab Al-Mufrad. Its chain of
transmission is good (Hasan), Ibn Baz, p. 26.