Quantcast Figure 2-15. DD Form 771 (Eyewear Prescription). - Outpatient Medical Records Branch

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g. DD Form 771 (Eyewear Prescription). Each time corrective lenses are
prescribed, this form is completed.
Copies 1 and 2 are sent to the optical
laboratory.  Copy 3 is filed permanently in the HREC. See figure 2-15.
Figure 2-15. DD Form 771 (Eyewear Prescription).
MD0751
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