sanyapong nimitwetthawon

2nd Grade Practical test [Slit lamp]

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Title Page

Site conducted
Conducted on
Prepared by
Location

EYE HEALTH CHECK

Hygiene

Over all
Using alcohol spray before touching customer
Slit lamp Set up
Lids & Lashes
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Bulbar Conjunctiva
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Palpebral Conjunctiva
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Limbus
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Iris
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Cornea
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Tears
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Crystalline Lens
- Slit width
- Brightness
- Magnification
- Angle
- Identify
- Fail
Manners while processing on customers

Signature

Trainee
Trainer
Manager

sanyapong nimitwetthawon

2nd Grade Practical test [Slit lamp]

Use this Template

Print as PDF

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