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Vision Cert.

This vision certificate certifies that an individual was tested for near vision using a Jaegers Chart within 12 inches and for color perception using an Ishihara Chart. The results for near vision testing of the left and right eyes with and without correction are documented. The certificate also includes the date of examination, next examination date, and the examiner.

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38 views1 page

Vision Cert.

This vision certificate certifies that an individual was tested for near vision using a Jaegers Chart within 12 inches and for color perception using an Ishihara Chart. The results for near vision testing of the left and right eyes with and without correction are documented. The certificate also includes the date of examination, next examination date, and the examiner.

Uploaded by

ali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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VISION CERTIFICATE

This is to certify that _________________________________ was tested for the following:


NEAR VISION
The above named person was tested on Near Vision with Jaegers Chart at a distance not less than 12 inches
(30.5 cm) and found to be satisfactory / unsatisfactory in reading the following Jaeger Number.

Left

: J1 / J2

without Correction

with Correction

Right : J1 / J2

without Correction

with Correction

COLOUR PERCEPTION
The above named person was tested on Color Perception with Ishihara Chart, shades of grey and found
to be
Satisfactory

Unsatisfactory

Remarks:-

Date Examined

Next Examination Date

______________

____________________

Examined By
______________

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