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Mrd.No 1	Name	Age	Gender	Visit No	Visit Date

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Presenting Complaints

Past Ocular History

Medical History

DM	HT	C.A.D	Prostate	C.O.P.D	Others

Addictions	Allergy History	Medical Ocular History

Visual Actuity

	VA	VA WITH PH	OLD GLASSES
RE
LE

Previous Glasses

	SPH	CYL	AXIS	NEAR ADD
RE
LE

Retinoscopy

RE		AXIS	LE		AXIS
HORZ			HORZ
VERT			VERT

Refraction

	SPH	CYL	AXIS	NEAR ADD	V.A With Glasses	N.V
RE
LE

Glass Type / Uses / Remark

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Investigation / User / Amount

Diagnosis

Special Advice

Remark

Councelling Remark

@include('opd/inctreatments')

Patient Checked

OPD Detail Print OPD Brief Print

@include('opd/opdpatientsummary')

@include('masters/inccommonmodal') @include('footerscript')