|
Op Note?
|
|
|
YAG?
|
|
|
OD
|
OS
|
|
Power
|
No. of shots
|
|
Indication for Sx Diagnoses OD
|
Indication for Sx Diagnoses OS
|
|
Indication Diagnosis Freewrite
|
|
|
Anesthesia
• • •
|
Surgery Center
|
|
Indication OD
|
Indication OS
|
|
Indication Freewrite
|
|
|
Preop Marking OD
|
Preop Marking OS
|
|
Preop Marking Freewrite
|
|
|
Back to OR and time out
|
Local numbing gtt
|
|
Contact lens OD
|
Contact Lens OS
|
|
Laser Armed
|
No. of shots ref
|
|
New Reference Field
|
Lens Off
|
|
Tolerated well
|
Comments
|
|
Signature
|
|
