| Parent File | Name | Number | Package | 
|---|---|---|---|
| VIST ROSTER(#2040) | EYE EXAM DATE & VISUAL STATUS | 2040.04 | Visual Impairment Service Team | 
| Field # | Name | Loc | Type | Details | 
|---|---|---|---|---|
| .01 | EYE EXAM DATE | 0;1 | DATE | 
  | 
| 1 | EYE DIAGNOSIS NARRATIVE | 0;2 | FREE TEXT | 
  | 
| 2 | VISUAL ACUITY RIGHT EYE | 0;3 | FREE TEXT | 
  | 
| 3 | VISUAL ACUITY LEFT EYE | 0;4 | FREE TEXT | 
  | 
| 4 | VISUAL FIELD RIGHT EYE | 0;5 | FREE TEXT | 
  | 
| 5 | VISUAL FIELD LEFT EYE | 0;6 | FREE TEXT | 
  |