vault backup: 2026-04-05 15:37:59

documents/medical/eye/jiang_LA_2021.md

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+---
+type: prescription
+category: eye
+person: Xuewei Jiang
+date: 2021-11-17
+provider: Maylin Gonzalez, OD — Eyed LA Optometry
+source: jiang_LA_2021.pdf
+---
+
+# Eyeglass Rx — Xuewei Jiang — 11/17/2021
+
+## Provider
+
+- **Practice:** Eyed LA Optometry
+- **Doctor:** Maylin Gonzalez, OD
+- **License #:** 14297
+- **Address:** 1150 18th Street suite 103, Santa Monica CA 90403
+- **Phone:** (424) 208-3107
+
+## Patient Information
+
+- **Patient:** Xuewei Jiang
+- **DOB:** 03/13/1993
+- **Address:** 11950 Idaho Ave. apt. 113, Los Angeles CA 90025
+
+## Exam Details
+
+- **Date:** 11/17/2021
+- **Expires:** 11/17/2023
+- **Rx #:** 168263508
+
+## Rx Details
+
+|    | Sphere | Cyl   | Axis | Near Add | Int Add | H Prism | V Prism |
+|----|--------|-------|------|----------|---------|---------|---------|
+| OD | -3.25  |       |      |          |         |         |         |
+| OS | -3.25  | -0.25 | 098  |          |         |         |         |
+
+- **Distance PD:** 58.0
+
+## Special Instructions and Recommendations
+
+| Feature        | Value         |
+|----------------|---------------|
+| Material       | Polycarbonate |
+| Tint           |               |
+| AR Coating     | Yes           |
+| Photochromic   |               |
+| UV Treatment   | Yes           |
+| Polarized      |               |
+| LensType       |               |
+| Instructions   |               |
+
+Signed: Maylin Gonzalez, OD