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El m dico examinar al solicitante personalmente y har constar en este formulario las condiciones f sicas en que se encuentre dicho solicitante. Agudeza Visual Ojo derecho sin lentes Correctivos 20/ Ojo izquierdo sin lentes Correctivos 20/ Ambos Ojos 20/ Condici n Cong nita Adquirida Ojo Derecho Observaciones Condici n f sica y mental del solicitante O dos Brazos Piernas Defectos f sicos o mentales Ha padecido alguna vez de epilepsia convulsiones mareos o cualquier condici n que cause estado de ...

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