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L. or ETDRS wall chart A68 Vision retest with near point card See next page A69 Revised 6/9/10 A29 Internal Medicine Concerns Alcohol Abuse/DUI in last 2 years Diabetes Diabetes corrected far acuity 20/40 OU on chart test Thyroid Rx or disease in last 2 years Blood Chemistry Panel CBC with differential HDL A03 A04 A27 Glucose serum send to lab A25 TSH A62 Medication Concerns current use for seizures current use for seizures use in last 6 months but denies use in last month use in last 6...
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