367-3 无损检测人员视力检查表.doc

文档介绍：无损检测人员视力检查表NDEPERSONNELVISIONEXAMINATIONFORMExaminee受检者Name姓名Gender性别 IDNumber识别代号DateofBirth出生日期Near-VisionAcuityOnaStandardJaegerTestChart[Dist.:12inches(305mm)]近距离视力检查 LeftEye左眼RightEye右眼BothEyes双眼Result结果Natural裸视力□ordingtoCIP(ChineseColorContrastdifferentiationchart,version5th),(中国色盲检查图,第5版),能识别第1~5组。□Acceptable合格□。□Acceptable合格□ments评语:ExaminationDate检查日期:DateofNextExamination下次检查日期:Examinedby检查Date日期Title职务