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00057_Bitmap_rgp order form fr 157
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.png
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Bitmap Image
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1997-10-29
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330KB
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414x399
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4-bit (7 colors)
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OCR:
nGr Order Form Clinic: The Borth Center for Ophthalmic Reseaic RGP Lens Patient[ - Address: 800 East Atwater Avono Ord Date: Address#: Phone Bloomington, Indiana 47405 Palienl ID B12-955-1093 Clinic Drd.# Phone: OD yeaysev= Lene Custom Lens Haberial: Fluoroper BO YEPesyBEpesy == Designt BC=Sph. Periph =Sph. # of PC#=2 yeayseyearsEve BC: 7.83 PM 0.75 Dia 9.50 0.2 : 8. 10 CE- 0.00 DEresyBEY -SYBEI Color: Blue PC1: 3.04 yeayseyearsEve Bland: Light Widlh 0.40 SEY = SyBEP -BYSE Spec. Degn: PC2 10.05 Lens Add 110 Widlh: 0.30 Edge Lit PC3 Edge 0.09 Clear Thickness: Widih -- #Eyesy= = Pesy == NDTES sEyesys =Yesy's=} GEYesy's =Yesy == - FOR REFERENCE ONLY - Sim K's 43.25 € 027 / 15.75 € 117 Comeal 0.53 Bccen. Lab: Lab Phone: DD Dol Ordered By Lab Fax OS Dot Delivery Lsb REF # +1 NO Dol#
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/Eyesysd.DIr/00057_Bitmap_rgp order form fr 157/00057_Bitmap_rgp order form fr 157.png)