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obsidian-yanxin/documents/medical/eye/lu_LA_2022.md
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type, category, person, date, provider, source
type category person date provider source
prescription medical Yanxin Lu 2022-07-05 Bijan Cohenmehr, O.D. lu_LA_2022.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 -1.75 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.