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    Patient Eyeglass Prescription Information: Date of Eyeglass Exam: Prescription Expiration Date: Eyeglass RX Type

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    UniqueEye Optique
    Jessica Johnson-Smith's multi-focal eyeglass prescription from March 16, 2023 expires on March 16, 2024. Her prescription includes different prescriptions for her right and left lenses for both distance and near vision. Her binocular pupil distance is 67.0. The prescription was written and signed by Dr. Jerome Kramer on March 16, 2023.

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    Patient Eyeglass Prescription Information: Date of Eyeglass Exam: Prescription Expiration Date: Eyeglass RX Type

    Uploaded by

    UniqueEye Optique
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    Jessica Johnson-Smith's multi-focal eyeglass prescription from March 16, 2023 expires on March 16, 2024. Her prescription includes different prescriptions for her right and left lenses for both distance and near vision. Her binocular pupil distance is 67.0. The prescription was written and signed by Dr. Jerome Kramer on March 16, 2023.

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    Jessica Johnson-Smith's multi-focal eyeglass prescription from March 16, 2023 expires on March 16, 2024. Her prescription includes different prescriptions for her right and left lenses for both distance and near vision. Her binocular pupil distance is 67.0. The prescription was written and signed by Dr. Jerome Kramer on March 16, 2023.

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    © All Rights Reserved
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    7 views1 page

    Patient Eyeglass Prescription Information: Date of Eyeglass Exam: Prescription Expiration Date: Eyeglass RX Type

    Uploaded by

    UniqueEye Optique
    Jessica Johnson-Smith's multi-focal eyeglass prescription from March 16, 2023 expires on March 16, 2024. Her prescription includes different prescriptions for her right and left lenses for both distance and near vision. Her binocular pupil distance is 67.0. The prescription was written and signed by Dr. Jerome Kramer on March 16, 2023.

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    Patient Eyeglass Prescription Information

    JEROME KRAMER OD FAAO


    175 I U WILLETS RD
    Name: Jessica Johnson-Smith
    Albertson, NY 11507-1342
    39 Geranium Ave
    Phone: (516) 333-0222
    Mineola, NY 11501
    Fax: (516) 333-0263

    Eyeglass Rx Type: Multi-Focal

    Date of Eyeglass Exam: 3/16/2023

    Prescription Expiration Date: 3/16/2024

    Underlying Sphere Cylinder Axis Add H.Prism H.Base V.Prism V.Base Base Slab Off
    Condition Curve

    Right Lens -3.00 -2.75 084 1.00

    Left Lens -3.75 -2.25 080 1.00

    Distant Near
    Binocular PD: 67.0

    Rx Notes:

    I have examined your eyes in accordance with current regulations.

    Jerome Kramer O.D License # TUV4046


    Doctor Signature Doctor Name

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