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documents/medical/eye/lu_LA_2022_modified.md

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+---
+type: prescription
+category: eye
+person: Yanxin Lu
+date: 2022-07-05
+provider: Bijan Cohenmehr, O.D.
+source: lu_LA_2022_modified.jpg
+---
+
+# Eye Exam Prescription — Yanxin Lu — 7/5/22
+
+## Provider
+
+- **Doctor:** Bijan Cohenmehr, O.D.
+- **Address:** 12222 Wilshire Blvd., Suite 105, Los Angeles, CA 90025
+- **Tel:** (310) 828-2010
+- **Fax:** (424) 832-3712
+- **Lic. #:** 10047T
+
+## Patient Information
+
+- **Rx for:** Lu, Yanxin
+- **Date:** 7/5/22
+
+## Prescription
+
+|      | Sphere | Cylinder | Axis | Doc | Prism | Base |
+|------|--------|----------|------|-----|-------|------|
+| OD (DIST) | -5.50  | -1.25    | 35   |     |       |      |
+| OS (DIST) | -5.50  | -1.25    | 148  |     |       |      |
+
+| ADD |   |
+|-----|---|
+| R   |   |
+| L   |   |
+
+| Bifocal | | |
+|---------|---|---|
+| TYPE | SEG. SIZE | SEG. POSITION |
+| | | |
+
+## PD
+
+| DIST | NEAR |
+|------|------|
+| 66   |      |
+
+## Tint
+
+*(empty)*
+
+## Remarks
+
+- 2nd Pair:
+- IMPACT RESISTANT, MUST MEET Z-80 STANDARDS. VOID IF ALTERED. VALID FOR 1 YEAR FROM ABOVE DATE.
+
+## Notes
+
+> FILLING THIS PRESCRIPTION CONSTITUTES AN AGREEMENT TO RE-MAKE LENSES AT MY DIRECTION FOR A PERIOD OF NINETY (90) DAYS WITHOUT FURTHER CHARGE TO ME OR MY PATIENT.
+> -NOT FOR CONTACT LENSES.