In the practice of his profession each licensed optometrist shall keep an adequate chart or record on file for each patient examined by him. He shall make a complete minimum examination and shall keep a record from actual tests made on each patient, which record shall show the following minimum conditions:

1. (1) Complete history and symptoms;
2. (2) habitual visual acuities;
3. (3) external examination, including motility tests;
4. (4) ophthalmoscopic examination recording description of all media and grounds, nervehead and vascular tree;
5. (5) phoria tests vertical and horizontal for near and far;
6. (6) tests for fusion near and far;
7. (7) keratometer (ophthalmometer) readings;
8. (8) refraction obtained retinoscopically;
9. (9) refraction obtained subjectively including tests for astigmatism and axis;
10. (10) amplitudes of accommodation, convergence and divergence;
11. (11) disposition of case and prescription with corrected visual acuities right eye, left eye, both eyes, including facial measurements.