JFK Assassination System Date: 10/1/201 Identification Form Agency Information Released under the John Kennedy Wesasgsgination Records oOllection Act of 1992 AGENCY: HSCA RECORD NUMBER:  180-10107-10235 (44 USC 2107 Note}. ases#: Nl S4756 Date: WO-31-2017 RECORD SERIES: NUMBERED FILES AGENCY FILENUMBER: 002420 Document Information ORIGINATOR: DOD FROM: NIELSEN, D.E. TO: HSCA TITLE: DATE: 09/29/1977 PAGES: =. 207 SUBJECTS : HALL, LORAN, MILITARY SERVICE DOCUMENT TYPE: LETTER CLASSIFICATION: — Unclassified RESTRICTIONS: 3 CURRENT STATUS: = Withhold DATE OF LAST REVIEW: 05/18/1993 OPENING CRITERIA : COMMENTS : Box 58. v9.1 ; , ] HW 54756 Docld:3227627166 Page 1
a Qe HW 54756 OFFICE OF THE SECRETARY OF DEFENSE WASHINGTON, D.C. 20301 September 29, 1977 Mr. James L. Wolf Select Committee on Assassinations U.S. House of Representatives Washington, D. C. 20515 Dear Mr. Wolf: As indicated in my letter of 21 September, additional Army records in the case of Loran A. Hall have been located through the Veterans Administration Headquarters in California. A certified copy of these records is appended hereto as Attachment 1. The documents provided do not constitute a complete service record, since these were destroyed by the 1973 fire at the National Personnel Records Center. However, the file contains substantial medical records and substantiates military service by Mr. Hall as follows: Length of Service Yrs. Mos. Days U.S. Army 9 Jan 47 17 Apr 47 0 3 9 Kansas National Guard 20.Sep 47 29 Jun 48 0 9 9 U.S. Army 30 Jun 48 4 Aug 52 4 1 5 . “5 1 23D Sincerely, D. E. NIELSEN Captain, USN OSD/Special Coordination Staff Attachment a/s $ tf Docld: 3227627166 Page 2?
> . a. YGENERAL SERVICES ADMINISTRATION * National Archives and Records Service NAME AND ADDRESS OF DEPOSITORY National Personnel Records Center (Military Personnel Records) 9700 Page Boulevard St. Louis, MO 63132 GSA FoRM 6791C (REV. 3/77} HW 54756 DoclId:32262166 Page 3
"> REPORT OF : SEPARATION - ARMED. FORCES OFTHE, 16. ENLISTED IN OR om TO A RESERVE COMPONENT... ~ ty 3 . vf! aware He sats 53 coos "seat spun y SELECTIVE-y # SERVICE DATA. "]18..GRADE>RATE OR RANK “AT TIME oF aritay Iq to ACTIVE SERVICE INTO. ACTIVE canvica Fon ee li ce {city and State). - - 527) ans ‘Eh tecd: . . : ISTMENT ALLOWAN cE PAID one ATENSIO® LIStMENT. IF ANT at ae 28. FOREIGN "AND OR SEA SERVICE r Ly | a a Tels sD Wek Ui. Wada * 804" cand beo = et ean i * an "oy ag. senvice @CHOOLs OR COLLEGES, COLLEGE TRAINING COURSES savTon “pat ae Th . " : . Qi. SERVICE TAAINUNS COURSES SUCCRSEFUL LY 7. GRAD cqupses: SUCCESSFULLY COMP! ETE : ks hed : COMPLETED on ’ 4 + . “* . ae 3 re = — ae “ > _ ua n & > 7 & %. - : Pieter, Dal 48, oy ee rhe oak . GOVERNMENT INSURANCE: TNFORNATION: IF PREMIUM I8-NOT PAID WHEN DUE OE WITHIN-THINTY-ONE »DAYS oR, INSURANCE Will TAPE. MAKE CHECKS R MONEY ORDERS PAYABLE 0 THE TREASURER OF THE UNITED STATES. FORWARD PAYMENTS FOR‘N.8,L.I..T0-THE COLLECTIONS UNIT, VA BRANCH OFFICE HAY- JURISDICTION OF AREA iN WHICH YOU MAINTAIN PERMANENT RESIDENCE. BORWARD PAYMENTS .. pore U.8.4.L.1, TO COLLECTIONS ‘DIVIS ON, VETERANS ADMINS- TION, WASIGNGTON 26, D.C. WHEN MAKING INSURANCE’ PAYMENTS: "BE BUBB TO “GIVE BULL, NAME. AND PERMANENT ADDRESS FOR MALLING PURPOSES, SERVICE RIAL NUMBER AND POLICY NUMBER(S) If KNOWN. a y TA, . sino OF insurance (amount and premium due tach month} a ka Ss ee att So TRIED APPLY TO CURRENT ren 3 TU ncetaees one ; Hecugle tea? tate : ‘is a orca ¥ ta “VETERANS, ADMINISTRATION: “REGIONAL OFFICE copy” © AR services 7 To. Vetergas Acmials tratio a; Regional: ; Office- Having Jurisdiction Ovet The: Area Tadicated
é REPORT OF SEPARATION ROM THE __ARMED FORCES OF THE UNITED STATES _ "3. GRADR—BATE-RANK AND BATE “OF DF APPOINTMENT : 0. DATE OF BIRTH pay | MONTH’ OF ENYGY OTHER THAN BY INDUCTION: . rr aoe Poot ge. Tar Ane TATE OR DAME AY Tuy fi] see lo, fee ae ay ; ‘pury | INTo Activa seavice is THLISTNERT, ALLOWANCE. PAID ON EXTERSION or ENLISTMENT, 18 ARY aro Pa WORTHS et & Acd We wy Fn ¢ ; 30. SERVICE SCHOOLS OR COLLEGES. COLLEGE TRAINING couasEes Anon : . . : : a * a . 31. SERVICE TRAINING courses SUCCESSFULLY POST-GBAD. COURSES SUCCESSFULLY COMPLETED : COMPLETED ‘ Be a STAAL : N RATION: 'f premium fs not paid 8 t ETRE premlun pal insurance will fa far National ah Berton, te daazce ‘bo Saletions a unit, V rn a the, main hee your our malting add address for insu: tes ment kite parce purpeses. payments for ies Washington 25, C. When making insuranoe baysnent he sure to give full name HY alle address for Insurance ene 36. TRAVEL OR MILEAGE ALLOWANCE INCLUDED a WAYOTAL PAYMENT = | o t126 ast under Boe ee win rn coe Bioed Group A a Oct 49 TDOP.PL550 pada - oe “Maabliity existing. nrtor to entry inte active service and not agmravated ‘by usditary Service SEEOOd50~20 “| GRAM. | HIGH COL- | OEGREE(S) MAR. | SCHOOL] LEGE Soe. ai ae & papaTion (St.,H.P-D., ounty, C! aaweod s Spetté D2 Parsons Kansas : C7 Oren LL. FORM . VETERANS ADMINISTRATION REGIONAL OFFICE COPY (ACL SERVICES: TO VETERANS. DD: ad JAN 50 2, 1 4 INDIGATED IN Tt ON BM OFFICE HAVING TIRISDICTION OVER THE. AREA ;
if fi SAVE THIS FORM. IT WILL NOT BE REPLACED IF LOST This record of job assignments and special training received in the Army is furnished to the soldier when he leaves the service. ‘In its prepara- tion, information is taken from available Army records and supplemented by personal interview. ‘The information about civilian education and work experience is based on the individual's ows statements. ‘The veteran may present this document to former employers, prospective employers, _. tepresentatives of schools or colleges, or use it in any other way that may prove Peneficial to him. LAST NAME—FIRST NAME—MIDDLE INITIAL MILITARY OCCUPATIONAL ASSIGNMENTS . RUE \ 10. MONTHS 11. GRADE 12, MILITARY OCCUPATIONAL SPECIALTY 2. ARMY SERIAL No, ~ 3. GRADE 4, SOCIAL SECURITY No. , 2 Pvt iBI Basic Training 17 224 450| Pvt 515 20 3802 (521) PERMANENT MAILING ADDRESS (Street, Cily, Counly,State)st—=~CS~S 126% W. 6th, Harvey County Newton, Kansas em A 6 DATE OF ENTRY INTO 7. DATE OF SEPARATION ACTIVE SERVICE 8 DATE OF BIRTH 4 Jan 30 @ Jan 47 | 17 Apr 47 9. PLACE OF SEPARATION Separation Point Fort Lewis, Washington ee Y SUMMARY OF MILITARY OCCUPATIONS ; TITLE—DESCRIPTION—RELATED CIVILIAN OCCUPATION NO MILITARY ASSIGNMENT: 4GO FORM Seen This form supersedes WD AGO Form 100, 16 July 1944, which will not be used. roa5835-1 t 194s 100 54346 Docld:32262166 Page 6 ; ‘ oe seer Ce ee an tee he Meaned wee c—wereegs
"MILITARY EDUCATION a ee a a 14, NAME OR TYPE OF SCHOOL—COURSE OR CURRICULUM—DURATION—DESCRIPTION . . ~ . ~~.) +: @ we =. Completed 8 weeks of basic training course included map reading, markemanship, manual of arms, close order drill, first aid and physical training. Performed duties as company painter. Painted Signs and buildings. CIVILIAN EDUCATION 15. HIGHEST GRADE 16, DEGREES OR DIPLOMAS | 17. YEAR LEFT OTHER TRAINING OR SCHOOLING COMPLETED SCHOOL . 20. COURSE—-NAME AND ADDRESS OF SCHOOL—DATE | 23. DURATION 2 s HS None. 1943 None 18, NAME AND ADDRESS OF LAST SCHOOL ATTENDED Newton High School Newton, Kansas 19. MAJOR COURSES OF STUDY Academic CIVILIAN OCCUPATIONS 22, TITLE—NAME AND ADDRESS OF EMPLOYER—INCLUSIVE DATES—DESCRIPTION TRUCK DRIVER, LIGHT: For 3 years previous to entering the armed service was employed by the Dawell Incorporation, Newton, Kansas. Drove and operated all types of heavy trucks including semi-~ tanker. Drove approximatly 150 miles per day over all types of - ponds. Did day and night driving. Serviced, lubricated and made — minor repairs to the vehicle, _ ADDITIONAL INFORMATION 23, REMARKS , Speaks, reads and writes Spanish language. COUNSELOR; Geddes — 24. SIGNATURE OF PERSON BEING SEPARATED 25. SIGNATURE OF SEPARATION CLASSIFICATION OFFICER 26, NAME OF OFFICER (Typed or Stamped) ELDON M SCHMIDT cwO  ——sdUSA ou, 8. GOVERNMENT PRINTING OFFICE 164581571 Hi_it756 Docld: 32262166 Page 7 . a tw awe + te ee
eg a OY fee = ENLISTMENT RECORD ,>5 5 3: ui | MSUULAR ARMY 777.47 7925 | CAST WA he EST MARAE AH OOLE RANE rw a . amey SMA. ma! a BACk (Boe Instreation 6.) Hall, Loran Eugene paeeiite: RAL7224450 _ White owe apne (Number and sirest or rural reate~1] none, 00 sate; cy, own o post office: county esd sae) (See Inctrectben 3.) PLACE OF ENLISTIOENT : . oa heatenainel 1 * car fi nA oom (if ralioted: NANSIGNED.” If enlisted far 3 poors, cae orn oF ulations, If ae som is meds, alee “REGULAR ARMY UNASSIO. . ad. ne From assagmannr we (If onli fer lene then ondy 62 author! sad 65 curr: regulations o Arup serial number fe nat ressriqned, show Sf emmidakadls evidence the 4 Tahdhd vervice We prostate, ‘eld verte! number, ether wise assign anser rom beck se heiee’ ding Ses ARMED. ad eed umber from Weck alieies I Jur Declaration Applicant. ty . DECLARATION OF APPLICANT (See Inetructio January.19%)_- +: +) >: bNewton Kansas pact (fae instruction 6.) . 1 poe VOU ACTEM OF Ter eeTeD EATEN (Jf naturalized oft Thite os - | Yes _ he 1 NUMBER OF GRADES COMPLETED IX GRAMMAR SCHOOL 6. LSNOER OF GRADES COMPLETED 1H FOES OHO 2, YEAS COMPLETED 18 COLLIE OR UERVERETY Right (8) me |_None oh 1. KAT IS TOUR CIVILIAN TRADE OR OCCUPRATIONT — u ¢ HOw LORS BO YOU One AT FT | 10. WUNKLY WARE Truck. Drive See _: Two (2)- Yrs. |$50.00 3. Ti, WAT SPRCLAL MILITARY QUALIFICATION OR OOOUPATION WAVE YOUF (Kram ple— Cost, sompang clark, rodte | is MAMTA SATS ae sree , . : - bo! () encnces () samen 1%, BS ANTYOME CEPENODXT OF YOU POR SUPPORT? Te MOMAGER AAD RELATIOMEMO? OF PEOPLE OLPUROENT OM YOU POR SUPPORT : ‘ .% None - MPREIOMED UNCMR SENTERCL OF 17. HAVE VOU EVER O0EX CISCHARIED OTHER THAN HOMCRARLY ROW THE T Wf yn ot eee Unter LS WA ON RAVAL SERVICE, THE MARINE CORPS. COAST GUARD, OR Remarks give dtails.) NO f . FAT OUARG IM AN ACTTAL WUACTIVG, O8 CURVE STATUCE ae Spar a ET SAC TU MUTATOR RL RS, i CORP, OM NS, OR TE, ng man ATL RAEI SSE HT (ifm, laa erie, dae, meters, ond cones 4 mpereion a from. : ‘ oy ~ a - ) . “* ots Sy + tee Ta, HAVE YOU EVER PREVIOUSLY APPLIED POR EMLISTIOONT AMO SFEX REJBCTID? (If 00, give date, place, and canst of rejection.) waa TOU ER HAD SPELLS OF UCDPCICOSRESS OR FAINT, CLIPS; COMPAS 8 FTTE, DOETHALITTS MOTD SE Gy : HA YO Ee ID LAT CmnOmac IMADACHER, MIGRANT TURTACLLOBE, ASTHA. 7000 Ot POLLEN ALAR, SS St Oo A ee ALT PEYEL Coon SACK PAM. ARTPBETI, RMURAIS, BULA EVER OT MOT ome STOMACH OW DUOC Tuan FAMILY BOIN TREATED AY A HORPTTAL, ASYLLM OM SAMITAMRUM FOR 8 Mah Ov Oe CONDITION, OF Hr yO THE LIME OF ALCOHOL, WAAIRUANA, RARCOTIC OR HABIT -FORSLNG ORUCSY (Uf enswer to ong part af the forageing fe. Y0s,” 4 sarwo repre. os oddittenal plate sheet af paper for details, Y necessary.) . ‘ aa No - . : er, fa TO TAME BEST OF YOUR KMOWLEDOE AND BELIEF A YOU ROW SOUND AND wHLL? (If net, give éaile:) . Yes ; ; . ; wo TON Kiepe THAT W YOU ARE REACTED BECAUSE OF AY DISQUALIFICATION KNOWN TO TOUTE SO, Be DO TOU KNOW THAT # YOU SEO. YOUR DG MTIGNT BY MEANS OF ANY FALSE STA) , WLR aoe re Ta RCCL TUNG OFFICER. YOU ILL HOT BE FLRBESHRD WITH AETURA TRAMFORTATION TO SReREPRERENT ATION OR CONCEALMENT AS TO TOL QUALIFICATIONS FOR SMLISTINT, ae a a oe MENON Te nt (OGTe Rasen Corps, Roles army Reset end Bates Te Pe er ae awe ie COMPS, MATIONAL QUAND, OR SR a Re AMONG ot mee Gee Moe HEN THEETO AMT EN EAD TOA HAT HY HOS SR SOT REKOROED ANG AME Seam A TTD AAD TWAT I PLLLY UNOURSTANO THE CONDXTIONS UNDER WICH | AM DRSTINS: * : . : 4 bi K) WO AGO Fo 94 Previous editions are obsolete. map sees & a. ete Oe
Care will be exercised by all concerned tn the eon of this form to obviate the necatslty tor returning {t for correction It will be carefully scrutinized after completion for errors and omiasiona and compared with the odio Fhe al antries made from it on the Service Record (WD AGO. Form 84 or. 24. we whi ch will be opened before this form ia mailed to The Adjutant General. This form will be used for enlistments in the Regular rmy. on] Yo. ‘ a a ; wos FOR THE: PREP ATION. OF THE. ‘ENLISTMENT RECORD. oo ee Only an an original will! be prepared. - Blue-black or black ink or typewriter, ribbon only will be need. Retained or dupheate ‘eofies ja record will not be prepared without specific instructjons from The Adjutant General. 2 The complete original record will be forwarded to The Adjutant General ty the recruiting officer. The: record of are rejected applicant will be marked “Rejected” at the top of the firat page and eat in case of an applicant with prior military service, 1 be filed at the place of rejection. The record of a ifiee scenes aving prior military service, who is rejected or phy ical reasons, will be forwarded to The Adjutant General. . Theen ent record will be mailed flat and will be accompani only by- such papers as are required in connection with the enl $. The name, race, home address, last service In the Army, ona “declaration of the applicant will be filled out at the-ststion’ where applicant is accepted for enlistment. ‘The remainder of the record will be filled out at the depot, post, or station to which the applicant is sent for final physical examination and entistment. Particular care wil] be taken to determine the bona fide home or residence of the applicant. “United States Army’’ will not be accepted az the home address. 4. The correct name of the applicant will be ascertained, and it will be written and signed exact! In each p mn the ‘form. A trial algnature. will be required before signing the Enlistment Record In the case of man nated te TT ine man's: name assigned on the record of reenlistment rain any particular from the name as shown on the siogataed rtificate or other available evidence of prior service, a notation will: be entered under “Remarks” on page 1 of this form eh ing the name +. under which. prior service was rendered. ia ge : 6. Service in the Army (See par: és , Boost 2 idee dervice in the Rogulat the Regular ‘Arniy Reserve, National Guard,. called or drafted into Federal Se: r ted Reserve Corps, or. Army of the Cala Si States. 6: Race will be indicated as white, eon, Thaler ( (refer to American Indian Rican, Caban, Mexican, Hawalian Filipino, Chinese, East Indian, ete,..As here empl “colored” will include ), Poarte R ine malattoes, and others negroid race or extraction. For mixed races, except mulattoes, the ‘of the white will be considered as synonymous with the race; for example: Mexican, Filiping, ete. ete. : : Asletice, 00 other | than members of the white or Caucasian race, wil, asa rule, be indicated by nationality; for example: Chinese, . The declaration of the applicant. will be! taken, befcre he has been ari ped, and any statement indica’ s ible cause for rejection will be followed vp by searching inquiry and examination: the result noted on the record.” eclaration ma: taken at'a substation by an enlisted man d eaignated by. the recruiting officer, if. no commissioned officer is available, in w! ich case the en! en enlisted man will sign as “Witness,” but the recruiting cer must verify the. statements of the spplicant before -enlistmen . & The physical examination will conform to the provisions of AR 40-105 or other p: 5 _& reseribed regulations, Deviations tions from nor mal, though not a cause for- “rejection, will be noted under the, proper headings. If waiver of defecte is secured from higher °°: authority, cite the authority, on : . . . Under the heading, “Remarks” (Page D wil be noted any authorized special aasigument, t a - FOR: THE PREPARATION OF DESIGNATION - OF RELATIVE TO BE PAID SIX, MONTHS’ GRATUITY IN CASE OF DEATH . - Every elit man, apn nlignent and regia othe Aryl hee e ls fly tir ities star ect ’ r 10, 1941 (Sec IV, Bul 36, 9. D-, ve aad the Act epproved December 17, 1948 (See. 1, Bul. 26, W. 1943) tion, or an estate is not eligible ie desig rt. The word  eache beneficiary igible, or the word Nowe" rei be written in the onion If thee ragraph 6 of Declaration Applicant ree. conjugal e ciary other than wife or. ae red to make the foll statement on line 3 in his own hand- : “I decline to designate any person as m: Semeteiad, ” or the statement may be Inserted with a rubber stamp and ini. y the enlisting man. a he. names a ben: on line 8 but does not desire to designate an alternate beneficiary, he will red to make the fall foll statement on jine in his own handwritingi'“I decline to designate an alternate beneficiary,” or the statement may be AS i ceried’ with Seaitien typerriter being uscd when sted man. . Names and addresses.will be legibly written, typewriter being when practicable, Except in signatare, names will be write . ten in ait treet nnd houst netaber, if any, will be given. . The signature of the enlisted man will be eased by the recruiting officer oF other available commlasioned officer, . Designation duly made and filed under: ct will.continue to be valid and sufficient during the term of enlistment for ye made until the enlisted man is separs rated from active service, or anti! a change among the persons eligible as beneficiary, tion the: or discontinuance of bility ogcurs, which event redesignation of beneficiary ‘will be made: ¢ on Desiguat n or Change of Relative to be Paid Six Months’ Gratuit a Case of Death (WD. AGO Form i). 14; Men who are discharged for the pu a leerpenty enlistment may be assigned to the organization in hich serving stt time of discharge in accordance with. relat tions om paragraph 23), WD. Circular 110, dated 17 April 1848). Su: mente are initial assignments only, « romise will be made or implied that these assignments are for any specified ean ‘of time beyond that authorized by, ean ar Department directives. . 18. Indicate initial: assignment of al ‘enlistees, if known, subsequent to the’ time the applicant takes the Oath st Enlistment: 7 aa a eee oH we. cortaumner reiatioe orryce if - - oe > oe “ a \penreanerenasomurmeny-oennendintemtbar er scadaneipeaianniiialsiiahsta thattninattitaistatrndee Pele HENS 9 0 airy MO i ahh a Te te od
OY propa ALTHORETY: (000 00 A390 AGREBL TO ACERT PRION Tem URNTED STATES 9UCH BOUNTY, pay, Kiri, AA CLOT 1s ARE Om MAY Bm ESTAMRIBNED OY LAMA AO BOLE San (90 Agim) THAT VSL ART 07 Aa ALE TO TA ETD STATES CAME TAT |W SERVE TR WONCTTLY AE FATAL AAA AA THE EINES OCR 0 CTL OEY Tat oncanes OF AE PEROOTT CF ek LTE STATES, AAD TO ORDERS OF TK OFFS APFOMTED OFA ACCORAIMG TO TE RULES AMD ARTICLE OF nae ; a . : LaRTe’Y Puxt Te ACNE CATH RO SLURRED Bs OLY amtRR 30 aac iso Sth aes January eee ast buen CARTY THAT THES SOLOME (906 NORTEL Y OPECTER BY la PREYIOUS TO HG SURECRIPTION YO TAL OATH: THAT | POUND His OCTIULY SOSCR we 0 Ral ORE OAL ‘fas WOM, FICAATICR, THT TO THE MEST OF WY AOSNT AND RLM. RALFLS Aid. LBEAL ZASMUNTS A TOUT IM GALETRAG HM HIG THE AERC OF TE UOETED STATES | PON STWERLY CONES SSSLATCA We GOVE Trt MCALITING wreee, _RATWOR CERTIFY TE TE AO OATH, APLAR A LAD OT APPT MPC i SLOCINPTION THT o cn . yA, 7 EDTARD A LAGRE,. Sapt, 9 Sunsary Court. tg AN ag: ee t Carefully wom pere with the mene ot Gop of page 2. : an . > ¢ 2 "The dates tn the onth andl cortiSeite must be the same, oo bl og , The pgnatare sonat be Mdantical with that subscribed te Decirstica of Applicant. . ” . so, _ MEAREST RELATIVE AMD: FERson TO SE NOTIRED ™ CAs oF EMERGENCY PULL WAM OF MEAREST RELATOR {thee then wife er scner chitd.) . waren, (Reais ed eg trai wae (oon pa aaa wa. y : 136 ¥.. 6th) Newton. Kang tie T, - a ee HE a DESIGNATION OF BENEFICIARY” TH PARES CCIE TO BEY SDUPICLAY AME OCRGAATID LOW: . oy 1 PLRL A MO ADORE OF, PE” fae wih We doe dowd ones 4 , . . : . oe . ot wre - _~ . > . ~ - a 2 PULL NAME 50 ADOARESG OF CACM MENCR C0. AND EACH DOPURGIRT COULD OO YEARS OF Ane (Lf there are ne children, 0 shale, . {/ the edsirene fe the sours’ at the wi’, 20 state, Do sat Bans Ft. Riley, Kansas —~- TYPED 01. RACE, AAD CROAMETATION CF TNE ATIETTNG me EDIRNE to PAGE Qap AO Be ~~. : “a
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‘ ¢ Oe ae eee ee DISCHARGESREL’ aoe. ve ; Lo Hh OSES Roe Oe > Glee | rem S | ERT, DCSE a HW 54756 DocId:32262166, Page 12
' oa 1 i 1 . : on . - 2 —r ee nm en nr ; ; Bs = : . wf . . ' * ‘ - haat sae ls yrs i , + \ can) ' aa ws ‘ ‘ ( . : By oe Des , Fy, a ; 2 .e . rose dy” at? od ° a . . afi Bia mencraccmnamaney Bra, : Le . craters ag ESS EI AIS COS ES = met ; . 3 oo , MW 54756 Docld:32262166 Page 13,00 2) fo ee note
OAR USE, CA? C¥as TOTS ah {18 may 52 . ae . . § ARM OR SERVICE 7 AGE TN YEARS ’ ur ORGANIZATION] (REGIMENT, SQUADEERL — cpl. ARPY - poe 505th yp Co . ; : a 10 TRANSFERRED FROM (FACLITY) = NV CIRCUMSTANCES UNDER WHICH ADMITTED 70 ; : - na. HOSPITAL (Calne OF ADMISSION: Direct Psychiatr; ae CALM OF AD ) , 12 DATE ENTERED ON ACTIVE DUTY IN COMMIS 7 = Sycniatric evaluation . UMITED OR GENCRAL SEAVICN FY COMMISSIONED STATUS AND WHETHER 3 MIUTARY OccuPATH : 3 ONAL SPEGALTY (rimiz) - 11 CORRE 30 Jume 191,95 None : . (any) CTIVE AEROMAUTICAL RATING | 15 ON FLYING STATUS PRIOR Ti —— : tos . - "PRESENT PERIOD-OF HOSPITALS No 16 AFTER CAREFUL CONSIDERATION OF CLINICAL RE NONE ZATION . CONDITION UPOM COMPLETION OF ‘CORDS. LABORATORY FINDINGS. AND PHYS) — . A CASE, AND UKE OF DUTY FinDiNGs FOLLOWING EACH DIAGNOSIS MNATION aes BY numaen ote OFFICER TO HAVE THE FOLLOWING DUG NOSIS. 1s Epilepsy, grand mal, NLD. EPIn,- | Soldier is wmfit for full op modified duty,, - Physical Profile 2211U,4 Does nct = (pan FT z MM RAATS te BA Abu sates, RAT Cae a FAA DAIS ALTE WTY BT MUAY C3) ves . DEGREE OF DISABILITY FOR MILITARY SERVICE (CHECK APPROPRIATENTEMS) TYPE OF SERVICE RECOMMENDED (CHECK ONE). mo EE SUALELED @ TOTAL 24 PARTIAL 2 PERMANENT | 26 TEMPORARY| 27 NONE. 7 GENERAL 2 PERMANENT . | 30: TEMPORARY N NONE “Yrs 7 No NO x . x a ro UMITEO UNITED b * . F7 STATE OISABILITY BRIEFLY IN NONTECHAICAL LANGUAGE toe : Evileptic seizures + no treatment available. TM THE BOARD RECOMMENDS THAT: ° ° _ Individual be ‘dfscharged from military Service for the convénience orethe government under provisions of SR 600-150-10. i: , 35" SIGNATURE OF BOARD MEMBER REQUIRED RESIDENT Ey ew REAURED (RECORDER 37 SIGNATURE OF THIRD MEMBER (NOT REQUIRED NAME, GRADE. ARM OR SERVICE (TYPE) WANE, GRADE ARN OR SERVICE (YAR) * NAME. GRADE ARM OR SERVICE (REQUIRED) HOWARD Cy REID | « jTBTER F. REGAN TIT JACK EV PRESBERG CAPT, AC . Tae AUST LT. UC, ; - UST LT. Mee, ® ¥ POSITION VACANCY EXISTS |. , 39 DATE APPROVED It J 2 yy 1957 # DATE APPROVED 2), J’ 1952 ~—- CITE APPLICABLE WAR DEPARTMENT DIRECTIVE SIGRATURE.OF C. 0. OF. HOSPITAL i GMA FREY OF STATION —~ : . Le : BRIGADIER GENERAL MITCHELL: | T ° NAME, GRADE, TITLE (TYPE THAME, GRADE. TITLE (TYPE) er " SIGNATURE OF LIAISON OFFICER J ME, GRADE, ( rs) . . oa De a Peek . R. A. MURCHISON aan ca RA Se et © a NAME AND GRADE OF LIAISON OFFICER (TYRE) - COLONEL, i. oo MHC. i ABEL, Ma jor- AGC, AsstAG WV QOATE DEPARTURE od 41 3DATE DEPARTURE . . @ TREMARKS - . . INSTRUCTIONS: Original and four copies to be prepared. Sign original only: Gignsture constitutes approval. At wo aco sie . 8-1 1 8 - tech 6 brief Clinical Abstract on 8 x iossineh white paper." || a . ' a A wens 50 F 118, 1 Oct 44, ” ip) *f possidte. Indicuto say known defocts upon en:ry on duly on & commissioned atatus for which a: Replaces WD A ‘orm 8-118, 13 20 Waiver was granted, . . . . . . angi Feb 45, which may te used. . baad Requind only it Commanding Officer of Unspital ts not authorised to lssue orders. . For Administrative parpases, : aw “ev. 8 eoveanniny painting OFACE 18-8008
+ ' Fame Fa Pesiirnd Div EMMISTMENT RECORD — Qt prr cn: t 20707 yer inox, By. ENBREGULAR ARMY MICs _Couoan pinihe A 47 224 460 | “oe qtate (arse y Pat re equnty aud ed (See Instruction 8.) PLACE OF ENLISTMENT . ‘ eo fun 4 : . tae | ENLISTED IN THE ony WG Wichita, Kansas FoR (if enlisted for less than 3 years, enter “REGULAR ARMY YNASSIGNED.” Uf gilisted enter arm or service and/or major fore elected ag auporiged by currest regulations. Ifno “REGULAR ARMY UNASSIGNED.") ( afin) my band 16.) RA Unas MG, ¢ 14 aks FOR ASSIGNMENT IN (If enlisted for less than 3. fir doe thifanacg blank, If enlisted f6 only az authori 38 TP! Ed orleans nee Oona) 7 . : fj LAST ENLISTED Seige” for $3 years, | LENGTH OF EN! fon ig made, enter figures.) eon wn a? i aa restave (CO reperan warronat cuaro [CT rare warionat, cuano DD aus enusten Oss D exc COMPANY, REGIMENT, ARM OR SERVICE, AND MAJOR FORCE - | DATE OF DISCHARGE “oe OF t * Bn RIC i7"ape 47 if unmistakable evidence of prior Army enlisted service is presented, assign old serial number, otherwise assign new |. MOTHER TONGUE number from block allotted for Regular Army. See AR 615-90. Whenever old Army serial number is not reassigned, show |t Wy: ieh old number under Item 18 under Declaration of Applicant. : ’ DECLARATION OF APPLICANT (See Instruction 7) 1. DATE OF BIRTH. 2.P . — Jen $0. . |*agweon, Kansie = t 3. RACE (See Instruction 6.) ~ 4. ARE YOU A omy OF THE UNITED STATES? (If @ Gaturalized citizen, state how, when, and where naturalized.) White es IS. NUMBER OF GRADES COMPLETED IN GRAMMAR SCHOOL | 6. NUMBER OF GRADES gunn IN HIGH SCHOOL 7. YEARS COMPLETED IN COLLEGE OR UNIVERSITY a. WHAT IS YOUR CIVILIAN TRADE OR OCCUPATION? “3 ‘ 4° LONG DID YOU WORK AT IT? R GE years Be) Truck Driver 1), WHAT SPECIAL MILITARY QUALIFICATION OR OCCUPATION HAVE YOU? (Erample—Cook, company clerk, radio | 12. MARITAL STATUS I Secu operator, supply sergeant, etc.) -- Fons OQ DIVORCED oO MARRIED oO WIDOWER 18, 1S ANYONE DEPENDENT ON YOU FOR SUPPORT? *| 14, NUMBER aia DEPENDENT ON YOU FOR SUPPORT one 15, HAVE YOU EVER BEEN CONVICTED OF Te HAVE YOU EVER BEEN IMPRISONED UNDER SENTENCE OF | 17, HAVE YOU EVER BEEN DISCHARGED OTHER THAN HONORABLY FROM THE ACIVIL COURT? (If so, when and wher of efnder U.S, MIL, OR NAVAL SERVICE, THE MARINE CORPS, COAST HP OR AFELONY? ANY OFFENSE? {+ Remarks give details.) NAT. GUARD IN AN ACTIVE, INACTIVE, OR RESERVE STATUS? 1B. HAVE YOU EVER SERVED IN THE U. S. MILITARY OR NAVAL SERVICE, THE MARINE EDR 25) , 0 INGA CTR Nathrtpe. 3 NB STR (If 80, Eee EUR COUT EAED PRS Bee the BOL Kens NG Fr. 2oSepthT to 29 ak 18. HAVE YOU EVER PREVIOUSLY APPLIED FOR ENLISTMENT AND BEEN REJECTED? = (If 80, give We place, and cause of rejection.) ’ 20, HAVE YOU EVER HAD SPELLS OF UNCONSCIOUSNESS OR FAINTING, EPILEPSY, CONVULSIONS OR FITS, ENCEPHALITIS, NERVOUS TROUBLE OF ANY SORT, HAY FEVER, SINUS TROUBLE, RUNNING EAR, EYE DISEASE OR INJURY, CHRONIC HEADACHES, MIGRAINE, TUBERCULOSIS, ASTHMA, FOOD OR POLLEN ALLERGY, DIABETES OR SUGAR IN URINE, BED WETTING, VENEREAL DISEASE, STOMACH OR DUODENAL ULCER, SCARLET FEVER, CHRONIC BACK PAIN, ARTHRITIS, RHEUMATISM, RHEUMATIC PEVER, HEART DISEASE, BROKEN BONES, DISLOCATED JOINTS, LOCKED KNEE? HAVE YOU OR ANY MEMBER OF YOUR FAMILY BEEN TREATED AT A HOSPITAL, ASYLUM OR SANITARIUM FOR A NERVOUS OR MENTAL CONDITION OR DISEASE? HAVE YOU EVER BEEN ADDICTED TO THE ALCOHOL, MARIHUANA, NARCOTIC OR HABIT-FORMING DRUGS? (Uf answer to any part of the foregoing is ‘*Yes,’’ give dates and ailments to which soe iy SS AOREAATENE' LHhkS, VoshingtoneFee 1EQT> Tr 70 THE BEST OF YOUR KNOWLEDGE AND BELIEF. ARE YOU NOW SOUND AND WELL? (If nofypie: details: Lee Ne & 22, DO YOU KNOW THAT IF YOU ARE REJECTED BECAUSE OF ANY OISQUALIFICATIONS KNOWN TO YOU AND CON- | 28. DO You.kfiow THAT IF YOU SECURE YOUR ENLISYMENT BY REANS OF ANY FALSE STATEMENT, WILLFUL CEALED FROM THE ACCEPTING OFFICER, YOU WILL NOT BE FURNISHED WITH BEBHGN TRANSPORTATION TO MISREPRESENTATION, OR CONCEALMENT AS TO YOUR QUALIFICATIONS rope. YOU ARE LIABLE THE PLACE OF ACCEPTANCE? . ‘TO TRIAL BY COURT MARTIAL FOR FRAUDULENT ENLISTMENT? | DECLARE THAT | AM NOT NOW A MEMBER OF THE ARMY (Opicers' Reserve Corps, Regular Army Reserve and Enlisted Reserve Corps excepted) NAVY, MARINE CORPS, NATIONAL GUARD, OR COAST GUARD IN AN ACTIVE, INACTIVE, RESGRVE, OR RETIRED STATUS; THAT THE FOREGOING QUESTIONS AND MY ANSWERS THERETO HAVE BEEN READ TO ME; THAT MY ANSWERS HAVE BEEN CORRECTLY RECORDED AND ARE ‘TRUE IN ALL RESPECTS AND THAT i FULLY UNDERSTAND THE CONDITIONS UNDER WHICH | AM ENLI§T ING. ia = a eat — \OURT BRORUITING DISTRICT ATURE) GRADE. ANY ORGAALZS a (To by witnessed by ; iting officer.) RE fr APP ‘ TUF eh. PE ak BONES CAS a T (See art a?) 7 a i : ’, ; nt A GRADE AND ORGANIZATION OF RECRUITING “Wichita, kanses Cuvee eRe Le Int NAME ARD GRADE OF CANVASSER ° ; Goorge E MrypdSet , u /act J a. an 19467 dun <¢8 DATE 38 3 ‘ANCE, 8
OATH AND CERTIFICATE OF ENLISTMENT Kansas oe a wawmmnnn_____Wichita._————«+ u Loran Eugene Hal) Se aS ,ACITIZEN OF THE UNITED STATES, DO HEREBY ACKNOWLEDGE Wut rant Rs Hirst nome—Middle name—Laat name) wy Lk Sen NG AQ. t . - i - 0 DAY OF. June 48 AS A SOLDIER wri zohan an 2¢ THe UTED STATES OF AMERICA FORTH PERIOD OF. UNDER THE CONDITIONS PRESCRIBED BY LAW, UNLESS SOONER DISCHARGED BY PROPER AUTHORITY; AND DO ALSO AGREE TO ACCEPT FROM THE UNITED STATES SUCH BOUNTY, PAY, RATIONS, AND CLOTHING AS ARE OR MAY BE ESTABLISHED BY LAW; AND I DO SOLEMNLY SWEAR (or Affirm) THAT 1} WILL BEAR TRUE FAITH AND ALLEGIANCE TO THE UNITED STATES OF AMERICA; THAT | WILL SERVE THEM HONESTLY AND FAITHFULLY AGAINST ALL THEIR ENEMIES WHOMSOEVER; AND THAT! WILL OBEY THE ORDERS OF THE PRESIDENT OF THE UNITED STATES, AND THE ORDERS OF THE OFFICERS APPOINTED OVER ME, ACCORDING TO THE RULES AND ARTICLES OF WAR. ' ’ ad } ¥ od ae e f ‘ ’ . f a yt . SIGNATURES f ; (First dome—Middle initial—Last name) | _ f* , 1 CERTIFY THAT THE ABOVE OATH WAS, SUBSCRIBED AND DULY SWORN TO BEFORE ME msx_OO DAY o____ June, d., »_48, FURTHER CERTIFY THAT THIS SOLDIER WAS MINUTELY INSPECTED BY ME PREVIOUS 70 HIS SUBSCRIPTION TO THE OATH; THAT I FOUND HIM ENTIRELY SOBER AND IN FULL POSSESSION OF ALL HIS MENTAL FACULTIES; THAT TO THE GEST OF MY a SUDGMENT AND wea cori HE FULFILLS ALL LEGAL REQUIREMENTS, AND THAT IN ENLISTING HIM INTO THE SERVICE OF THE UNITED STATES 1 HAVE STRICTLY OBSERVED THE REGULATIONS WHICH GOVERN THE RECRUITING . , SERVICE. U FURTHER CERTIFY THAT THE ABOVE OATH, AS FILLED IN, WAS READ TO THE APPLICANT BEFORE HIS SUBSCRIPTION THERETO. 4 Sept recruiting officer) . . ta , ‘ 7 (Typed name, IK and organization of recruiting officer) 1 Carefully compare ‘with the name at top of page 1. 2 The dates in the gath and certificate must be the same. § The signature most be identical with that subscribed to Declaration of Applicant. a i NEAREST RELATIVE AND PERSON TO BE NOTIFIED IN CASE OF EMERGENCY FULL NAME OF NEAREST RELATIVE (Other than wife or minor child.) Mre Warde Adelle Hall RELATIONSHIP ; . Appress (Number and street or rural route—Zf nonc, 20 state; city, town, or post office; State or country.) Moths 1263 West 6th St., N. ‘Kansas PERSON TO BE NOTIFIED IN CASE OF EMERGENCY | . . a. Mrs Marie Adelle Hall RELATIONSHIP Uf feieha, 80 state.) ADDRESS (Number and street or rural route—I/ none, eo state; city, town, or post office; State or country.) Mothe: 126% West 6th St., Newton, Kansas DESIGNATION OF BENEFICIARY ‘THE PERSONS ELIGIBLE TO BE MY BENEFICIARY ARE DESIGNATED BELOW:” 1. FULL NAME AND ADDRESS OF WIFE (Zfno tife, or if she is deceased or divorced, so state.) -- - a +. None .. Lo, Tee, i : aod ’ ‘ . a 1 ‘ . . . . ce eee ° i - Far EEpEIEUEDUUNEEE 677 UUEEENUINDT'SIT PHIRI“? SUIETW ODEN 107 SNEENTEENEDITENT OENIT PO" EDRENT SE EERIE re 2 FULL HAME AND ADDRESS OF GAGS MINOR CHILD AND EACH DEPENDENT CHILD OVER 21 YEARS OF AGE (Jf there are no children, 80 atate. Ifthe address is the same as the wife's, so state. Do not s epeat address. , ‘ene ‘ 8, IN THE EVENT OF MY LEAVING NO WIDOW OR CHILO, O8 ER oO (See Instruction £0.) ae Marie Adslle’HalL~Wether, 126} West 6th st., Newton, Kansas 4 IN THE EVENT OF THE DEATH OR DISQUALIFICATION OF THE LAST-NAMED DEPENDENT RELATIVE BEFORE PAYMENT IS MADE, | THEN DESIGNATE AS MY BENEFICIARY THE FOLLOWING RELATIVE (Give name, relation, ship, and address.) {See Instruction 10.) <, NY ~ ur Jack F Ball, Fathe , ges West 6th ste, Newton, Kansas > BEFORE PAYMENT IS wine, {THEY WESIGNATE Ne BENEFICIARY THE FOLLOWING RELATIVE (Give name, relationship and address.) ed aan aS - Wichita, Kansas IME, GRADE, AND ORGANIZATION OF WITNESS ATTESTING SIGNATURE £1 Y J SHELTON, lst Lt Sar Sumer, val Z ce is whe
4 : “ . | : PHYSICAL AND MENTAL EXAMINAT| beet LAST NAME—FIRST, r IODLE RAME ARMY SERIAL No, DATE OF ENUSTMENT ae by ° spe Oe Eugene RA 17 224 460 | White 80 Jun 48 1 mech HISTORY—THE MEDICAL OFFICER WILL ELABORATE UPON THE CONDITIONS LISTED IN ITEM CONCERNING PHYSICAL DEFECTS AND USE OF HABIT-FORMING DRUGS ON N PAGE 1 AND UPON ANY OTHER KNOWN MEDICAL FACTS (If necessary, use additional sheet of paper.) 2 ; INTELLIGENCE STANDARDS HIGH SCHOOL GRADUATE? | ENGLISH SPEAKING? . ~ | QUALIFICATION TEST (Form used) SCORE ~ . | ILLITERATE? DOES APPLICANT MEET MINIMUM INTELLIGENCE : STANDAR CJ ves L_Igno L Ries Ono Nett W17-IT Ovs no YES 1 no & COMPLEXION . ee 17, TEETH = (Indicate reatorable carious teeth by O; nonrestorable carious teeth by |, missing natural teeth by X, teeth replaced by denture—horizontal line over X a8 XXX and teeth replaced by fired bridge—oval to include abutmente—as & x 6), GOUORGFHAR =. | SCOLOROFEMES :,, f° yocm At _ Cless II Baal Hazel RIGHT . . LeFT 6 POSTURE 7. FRAME 8 7 6 5 4 3 ee 2 ee ee x 6 6 WW 2 (10 8 s H za good Mediun “ 6 & HEIGHT (Inches) 9, WEIGHT (Pounds) 18, MOUTH AND GUM ASNORMALITIES . . : 7) i 189 Nons 10, VISION 19. CHEST (Af nipples) © : 20, MEASUREMENT OF ABDOMEN UNCORRECTED "CORRECTED _— DISPIRATION 40 INCHES: EXPIRATION 84 INCHES AT UMBILICUS $2 INCHES Rich eve2n) 90) RIGHT EYE 20/ 21, EVE ABNORMALITIES | ‘ . . 22. EAR, NOSE, AND THROAT ABNORMALITIES LEFT EYE 20/ 20 LEFT EYE 20/ None None it, HEARING (Whispered voice) . 23. CARDIOVASCULAR SYSTEM RIGHT EAR ; LEFT EAR as |. Normal 12, PULSE 24, LUNGS . Clear STITING : AFTER EXCERCISE 88 j 20s cuest x-rays 2 MINUTES AFTER EXERCISE 88 18, BLOOD PRESSURE 28 SKIN 27, VARICOSE VEINS SYSTOLIC 3 3} o— ouTOLS 80 Clear ‘ None 14, URINALYSIS 5° . 28, HERNIA . 29, HEMORRHOIDS ck pA SAR Enlasged Ring L & R Si None . 1.020 Weg. | mx. aspownat viscera 21 GENITALIA ALBUMIN Neg microscoric } Normal Nor 1 18 NEUROPSYCHIATRIC .” . 82, MUSCULO-SKELETAL DEFECTS 33, FEET : - . ‘ . "Jig: ENDOCRINE DISTURBANCES a ‘| 94, RESULTS OF LABORATORY EXAMINATIONS, WHEN MADE , 35. BLOOD SEROLOGY vOone 48, REMARKS ON DEFECTS NOT SUFFICIENTLY DESCRIBED ABOVE (Use additional sheets if necessary.) ; 37. OTHER DATA 38. SUMMARY OF DEFECTS IN ORDER OF IMPORTANCE, IMPRESSION OF PHYSICAL FITNESS 99, | CERTIFY THAT | HAVE CAREFULLY EXAMINED THE APPLICANT AND HAVE CORRECTLY RECORDED THE RESULTS OF THE EXAMINATION; AND THAT, TO THE BEST OF MY JUDGMENT AND BELIEF 9 HE IS MENTALLY AND PHYSICALLY QUALIFIED FOR SERVICE IN THE UNITED STATES ARMY IN A GENERAL SERVICE CAPACITY, 0. HE IS Oo PHYSICALLY | MENTALLY DISQUALIFIED FOR SERVICE IN THE UNITED ST. ‘ATES ARMY BY REASON OF: , Wichita, Xansas DATE , name (Typed or stamped) 29 Jun 48 fers MAURICE M TINTEROW . ED ‘When indicated. ‘Check blocks indicated. Page 8 of WD AGO Form 81. 1 May 1946 w FINGERPRINTS—RIGHT HAND (Fingerprint impressions will be made in this space in the ease of every man enlisting and reenlisting in the Regular Army)
ARMED FORCES MODIFICATION Standard Form 88& PaoMuULaaTED Mance 148 _. 8 By BuReAw Of THE BUDGET =.” . °° ; . thet ot a RT OF MEDICAL EXAMINATION = (14 ,% : . 4 INSTRUCTIONS, FOR PREPARING THIS FORM.—N. S. A. represents No Significant Abnormality. In Items No. 20 through . No. -41, if ahnormal,'describe in space ofeach heading, or under’ No. 42, “Remarks.” or if necessary on additional sheets the same ! sizé.' Write on each sheet name, date of birth, and identification number. 1. LAST NAME—FIRST NAME—MIODLE NAME ~F : “| 2 PLACE AND DATE OF EXAMINATION Hall, Loren Eugene Det_-( 9 Med Det, APO 172. & DATE OF BIRTH %. AGE IN YEARS | 5. IDENTIFICATION NO, _, & PURPOSE OF EXAMINATION " LAST BIRTHDAY ; 4 Jen 1930 21 RA17224450 Discharge & Reenlistment 2. SERVICE, DEPARTMENT, oR AGENCY 9. ORGANIZATION PO 172 10. GRADE, RATING, OR POSITION US Army : MPC 52lst MP Svo Plat Cpl MM, SEX 12, RACE 13. HOME ADDRESS (Séreet, or RFD number, city, zone, State) ia Le 111 South East 7th, Newton, Kensas . F OF BIRTH 15. OTHER DATA 16. RATING OR SPECIALTY 677 (Time in this capacity) rovan =~ 2 Yrs LAST 6 MONTHS 677 17, MEASUREMENTS 18. BUILD (Including frame and figure) .| 19. TEMP. WEIGHT HEAVY OBESE Stripped) Pee || coe 21. LYMPH GLANDS AND LYMPHATICS N.S. A. [4 22. HEAD, FACE, AND NECK—N, S. A. 20. SKIN INCLUOING HAIR DISTRIBUTION, THICKNESS OF NAILS, TATTOOING, AND SCARS See Per #42 23. NOSE, SINUSES, MOUTH, AND THROAT=N. S, A. 24, EARS—A, CANALS, EXT. EARS=N. S. A. (9 C. HEARING (Whispered and spoken ovice at 15 ft.) D. AUDIOMETER | 26 | sz | | ons | ase. | . . ’ DECIBELS . LOSS B. DRUMS—NO PERFORATION 4 NSA. Pi err wi15 ANS: sv 150 B. PUPILS—EQUAL {3 NORMAL TO ACCOMMODATION Df TO LIGHT 25, EYES—A. FXTERNAL EYE, RIGHT EYEN. S. A. ie LEFT EYE—N.S. A, ps4 C. ASSOCIATED PARALLEL MOVEMENTS, NYSTAGMUS—N. 5. A. [x . D. DISTANT VISION E REFRACTION (Manifest) (Cycloplegic) STRIKE OUT ONE F. NEAR VISION—(At 14 inches ; ricut 20 &Oconn. to 20/ by sc cx Rel Mays owl tz Zest Chert tert 20f 2Ocorn. to 2/ BY so ex Le] | corr. to By G. COLOR vision—N. $. a. LY vestusco Me PIP | 2 g RH. La. PRISM . PRISM " USpeciiy distance) ad mx DIVERGENCE CONVERGENCE Cover Test(18 foet) Orthophoria : I. RED LENS—N. S.A. [7] «| 4s FIELD OF VISION—RIGHT—N. S.A. [] LEFTON. S.A. [7] K. DEPTH PERCEPTION TEST USED SCORE L. OPHTHALM “RIGHTN. SAT. M. ACCOMMODATION—RIGHT LEFT N. NIGHT VISION LEFT=N, S.A. . .. TEST USED . - SCORE 28. DENTAL—INDICATE BY SUPERIMPOSING PROPER SYMBOL ON TOP OF NUMBER OF TOOTH; I. E.. RESTORABLE CARIOUS TEETH BY O. EX: TRAGTION INDICATED BY /, MISSING NATURAL TEETH BY X, TEETH REPLACED RY FULL OR PARTIAL DENTURE HORIZONTAL LINE OVER XXX, | -—~eeeeemveernnereneener—ee MALOCCLUSION-N. S. A. (HF REPLACED BY FIXED BRIDGE BRACKETS TO INCLUDE ABUTMENTS AND LINE UNDER TOOTH (1 >< 3), CROWNS BY C, IMPACTED TEETH PERIODONTOCLASIA—H. S.A BY #, FILLINGS PRESENT IN TOOTH BY F. NORMAL TEETH BY N, WHEN DECIDUOUS TEETH PRESENT INSERT LETTERS IN RELATIVE POSITIONS, | —_——ee—anene——smennmnrnmens . Se A. fi EXAMPLE: a . ABCDE ABOVE OR BELOW G4321 12245, cote . GINGIVITISHN. S. A. [4 8 FF Oo ew XX OXP OTRN TN NCR N 876 5 43 2 1 1 203 4 5 UL REMARKS AND DISQUALIFYING DENTAL DEFECTS ~ po bi WW A 21, PULSE RATE AND BLOOD PRESSURE (Arm at heart level) phe Wke bh | a cuss TT SITTING: PULSE , BPs LLO vn 70 RECUMBENT: PULSE 60 BPs LIB » 6E STANDING (S min.): putse OV B. Pa: S. @ wv. 8 SITTING: PULSE AFTER Exercise 66 :2 MIN, AFTER - OE 2. LUNGS=N. S. A. ng) CHEST—N. S. A. [J 29. CHEST—N. S. A. [X} NOT DONE 30. HEART—N. S. A. (KI . 31. EKG—N, S. A. NOT DONE [Al : Unclude breasts 4 X-RAY a) O : j Pa wr ‘ - for females) : 32. VASCULAR SYSTEM—A. ARTERIES AND VEINS-W. S. A. [Xj B. VARICOSE VEINS—NONE [} :
\ - a ABDOMEN AND VISCERA—N. S. A. | j MASSES—NONE . . S. AL . . A. LIVER--N. S, A. B. SPLEEN—N. S.A. [Xf] Cc. ty See Par #42 3 34 HERNIA. (If present deacribe location, size, shape, reducibilily) (Complete or incomplete) ne , NONE 38 ANUS AND RECTUM—HEMORRHOIDS, FISTULAE, OTHER ABNORMALITIES . N S.A, i 3%. VENEREAL DISEASE 37, ENDOCRINE SYSTEM N.S. A. [Xf NONE ° 3%. G-U SYSTEM N.S. A. @ (Cnelude prostate exam. if indicated) PELVIC—N. S. A. Cl VAGINAL DONE O OR RECTAL DONE UC) 39. SPINE AND EXTREMITIES—A. BONES—JOINTS—MUSCLES—N, S. A. {A B. FEET~N. S. A. . C. GAIT—-N. S, A, 40. NEUROPSYCHIATRIC~A. NEUROLOGICAL. (Consider CRANIAL NERVES, MOTOR STATUS and COORDINATION, REFLEXES, SENSORY STATUS EQUILIB- RIUM, Always mention EXACT LOCATION.) _ 3. PSYCHIATRIC AND PERSONALITY. (Consider BEATA VIOR, COMPREHENSION, COHERENCY OF RESPONSES, EMOTIONAL REACTIONS, ORIEN’ TATION, MEMORY, and SIGNS OF TENSION.) . . oo 7 ee D. PERSONALITY . (If anawer fe yes, TEST USED : Scone DEVIATION Oran Gd ce i ” , . YES NO recommendations A. NEUROLOGICAL—N, S, A. B. PSYCHIATRIC—N. S. A. C. PSYCHOLOGICAL ; . ; f . [4 ea TESTING TEST USED . SCORE 0 under item No. 42) al LABORATORY TESTSA. SEROLOGY ° aS qpuMn we C. BLOOD TYPE AND CLASSIFICATION USED Specify éesi used—Res . og er . . 4 ° > fian 4 . <ahn-Negative — $.6h _ A” International Rh factor Positive D. OTHER LABORATORY EXAMINATIONS Negative None Sar "Pe. "Scare Hoth wyotrows, ort leg bectaide , chronic lichan right hand appendectomy 1939. — , ver #55~ Slight enlargement of liver.‘ Possible Hepatitis in 1648 . Patient at Field Hospital Regensburg, Germany. i . 4o other significant history. ca co r REMARKS (If “Physical Category” is other than A, specify reasons for such classifica tion) ; : : , . . 33 FURTHER SPECIALIST'S EXAMINATION INDICATED [—] YES (A NO, IF YES, SPECIFY _EXANINEE (15) OR (IDNOTIW Strike ouf one) QUALIFIED FOR Vv ‘TYPE OF QUALIFICATION General Service IF NOT QUALIFIED, LIST DISQUALIFYING DEFECTS AND RECOMMENDATIONS Oe q 44, SIGNATURE OF PHYSIGIAN _ A NAME TYPED OR PRINTED = Pod » DD. f Mee yore — ENRICO D. CARRASCO, Major MC ry sign RE p NAME TYPED OR PRINTED 6. SIGNATURE, PF DENTIST,OR PHYSICIAN (Indicate whlch) , NAME TYPED OR PRINTED _ Ya YL A} p A. ‘WALTER W. TUCKER, Ist Lt DC a, SIGNATURE OF REVIEWING SFFICER NAME TYPED OR PRINTED @& . DATE | . ; a Se . . : a . a U. $. COVERNM a Orrick «=. 16-—-G4662-2
_ » REPORT OF PHYSICAL EXAMINATION OF. ENLISTED PERSONNEL PRIOR TO DISCHARGE, RELEASE FROM ACTIVE DUTY OR RETIREMENT philis Regi “Tn 6/8? [Closed in S77" “every terete STATEMENT AND MEDICAL HISTORY OF EXAMINEE , w sal ka time do you have any wound, ip or disease which is disab ng? If answer is yes, list those conditions Bret under | Yes or No VW. List signilican: inepred wounds, and injuries. State circumstance a under which wounds | 2 3 d Laren i 1 mE |_AMS 3° ° PD S* | 4. Heart aie en fog Ristorys OF i aca eyunrrrs |e no no ao" no a: Bac nyury wise «of spine-4945-In ‘Army Feb 47 =a mo! yes| no | ledigan ¢ » Wn. — RECORD OF PHYSICAL EXAMINATION { 12° Teeth—Indicate restorable carious teeth by O, non-restorable carious teeth by /. missing natural { 13. Mouth and gum abnormalities ‘ teeth by X, teeth replaced by denture, nerizorat line over X, os KXX ond teeth replaced . | jmw RIGHT EXAMINEE'S LEYr [Dental proathesley- Werviceablliy 6 G 4 38 -K 2X 8 4 5 6 7 8B. 6 1 & WY @ lh Ww 8 . 9 bn 2 BM bb none . ; iS. Skin §. Genlto-Urinary (And pelvic tor women) “Ti. -Venarecl diseases | Right rectus scar 4" * normal : none ' none ; none normal | I.. Musculoskeletal defect Fest Abdominal Wall and, Viscera | none 7 normal | normal oo. 3. Blood “pressure a. Sifehe rough apical | rraale pel a amediately alier] Two minutes sesielic murmur - 10 4 8. Chest X-ray 9. Height (Shoeless 0. Weight (Stripped) no significant . prmel 7 abnormalities - 70 | 168 - Lbs. 3 Paychlatis Siegaodls © $3. Endocrine Hater normal | normal ‘normal ye ities ; . - Uncorrected — ‘Vision —— Corrected 36. Urinalysis . . , Right eye Lelt eye Right eye aft eye Sp. Gr. Albumin Sugar Micre. 6* , é . , none; none none oy =P m2 | mn 20 2 9630, ; ties 8. Hearing (Whispered voice) . . Blood serology i a em ight ear , ft ear a eg, eo ; : ative none * . 15 yg | 25 P hn-neg ore ee SESE [eam] a |" eee gy om too [ea oe a ST ease one : Yes or No | Yesor No | Condition: Yes or No stand: for discharge? nditiog: au, - no -,; no : 1lb yes ‘TE not, state why 3. Homarks, ep cial fests, or other defects (Continue on back) “9 ste * ft “ Date of examination. “5. -8. Apr 47 Ft Tents Wn T name and grade “C W HOCH CAPT MC : ° ter 4* Incurred while in INSTRUCTIONS: ws wo AGO f Hr 38 : 7 Puce to orival at <Pior to entrance military norvice, Sheet 1. Send to The Adjutant General This rm pends rm. WD ASO Wr agaraclod EY milny eorvce © selec, TO ghost 2. Wark atest ci ele Form aia ise are echoed. J Aggravated by military service g¢ When indloated. sheet 3. Laboratory Reports form (WD AGO Form $8-1) ST 36—40762-8 HEC. 8. CovERNMENT PaINTING OFFICE
see REPORT OF BOARD OF REVIEW 4 . ~ . . — (See Instraction 2) From a careful-considerction of the case ond a critical examination of the enlisted person, we find that: 1. He meets physical and mental standards for discharge. 2 He meets physical and mental standards for discharge except.as follows: $._ The defect, wound, injury, or disoase is likely to result in untimely death. +4. The defect, wound, injury, or disease is likvly to result in permanent disability. : ‘*§. in our opinion, the defect, wound, injury, or disease was incurred in line of duty in the military service of the United States. ems ue “1, This report will be made out for all enlisted sonnel immediately preceding separation by discharge and releose from active’ duty, unless dlacharged flity, tirement for service. on @ certificate of disability, or retiremo: ond the certificate of the examining surgeon do not agree, the case will 1 h es only, 2 It he bt tebe are of he enlisted maar under item ten (10) then two medical officers, convened in accordance with appropriate Army Regulations. 9. Report will be prepared in duplicate. Each item provided for will be completed with an oppropriate notation. The original will be signed.
| ; HAD GEN HOSP “MALL, Loran E . B. WARD C. RELIGION D. PREV. ADM. 2. REGISTER NO 3. ARMY SERIAL NQ. 4 GRADE gt Obs For . 85 "22; P| ko 0 497 | 17 224 450 Cn) Varde imran Rall “Cinased) Co D 130 Tne Bn (1264 W 6th St Newton gran s/c 107 SOURCE OF ADMISSION an JFi/e1/a | Pir Cas Prop Sta Ft Lewis jin Time 2025 TIF AAP. INDICATE PILOT, NON-PILOT FLYING PERSONNEL. GROUND PERSONNEGOWAVIMIO er ra 11. FINAL DIAGNOSIS, ADDLTIONAL DIAGNOSES. OPERATIONS, CHANGE OF STATUS Undtegnesed- ti searesonK Syncope, cause undetermined Yoo ~ Yoo Dsease of Undedunin ta Chae 9172-023 Lumbar puncture, 21 Feb 47,’ spinal fluid negative, ma f’ Specialized treatment KP Reconditioning Class III A PROFILE SERIAL Tapa nF : a goer / 1 Paar OF DUTY fe. fistartiie av ATL Tete Wi BVAYE : | 7 ey a | i. No, EPTS -AR 615-365 L. F. Jenk, Yat Lt., Mc \ — a WD MD FORM.55A a (Revised), - (WHEN A ptgOF 1 1 FEBRUARY 1949 ey ire e
arr MADIGAN GENERAL HOSPITAL a * _¥orm 83 B , ! Moxpica DerantMent, U.S. ARMY H (Revised May 31, 1939) ~ - CHIEF COMPLAINT—CONDITION: ‘ON ADMISSION—PREVIOUS } PERSONAL HISTORY Chiat compat niece ont “a %) ° ME. | ; General appearance 5 and condition on admission: *; am ae Y oa Ae sates 1 tig fs fot bribed “ Mi yearn, itd Soe, ae “ss . o Ootapation: Cvrévan - Fimerl hee He Nee a ~ ee een ot) WOOF AY " ‘Tropical service os ~ . 2S Habits (alcohol, tobacco, drugs): o* . ph DAL : Cty. . . ‘ . * 7 of 4 a4 . . as *, _ = +, 5 fla, : Pe. : jp Ais @ oor DL wots wee te nn Cn wee < : { i -, _ we CB x! , a - ; . . * we a . a ; me ; . . . . a . “ ae . | OA CPE ced MKT. 7 eva 0 CPT OMAR LT ne | Previous personal history: | { H i aeaaa OC vs aa Lae. varte u ~od ote Seer, Ne . vos . A ar . “\ es 4 es - ae mee 2 a ol. Drie APD HA, Ein hp mp ELEM dio ety - No ” “ . . Ll . “¢ ee ae et er Pt Os or I ee RARE ee ly Wy gon. wh ong” cote geting ~ 1H Cae] in & . , iv Jak, i I | | Venereal die oe . | H @ r/) (ovr) , me . : ‘ 10185101 WY aALas. Rosldia2262166Baus23.—.. a ne ee { f we Lg Z ‘ { |
‘ow an 4, Tn rot | Mg ln = =e JOE (etegie vhaae clon) ee ~ lah A Lie PIPES a“ ex ) — hat we . Yau D4 O, (OO C i. 2d. acon, harms - vouch Ap ee i, Ae atin hepe fey a | | ee Okt Ofer) 2 Hy en @ Dat AUN (We hake LEU CL. yn  faef Bi? an , ae
sl an at nn ° bad ° 2 . . 4 5 Form 35 Ce s < 1 MEpIcAL DeparTxMEnt, U.S. Agu? . H (Rewised May 31, 1939) PHYSICAL EXAMINATION. Hall, Leran &. Pvt. : Height: Normal! weight: Present weight: Skin: ; - rr Be H  ) i Head (including special seuses, nose, mouth, throat, and pharynx): No. bumps or increased tenderness Neck: No increased stiffness, or enlarged glands or goiter Thorax: Symmetrical | ' Lungs: i Clear to auscultation and percussion Vascular system (arterial and venous): \ Normal ’ | Blood pressure: Systolic eenneneesces VA LE aenannneee ; diastolic ....-....-.- x Z ecsenreceneseesuconenaees | Heart: ye , . , | ; (ovzr) 10~18816 i a
i is .- i - - i 3 Hy . : i ‘ Fe i = & oa a © i “ES , i ; as : : a 4 : i aa 2 i P it P wa Hi ‘ ie) t- mi Pos Es . . Hy un 7 So, 8 : J | fi Oo « Cy ra i E . 3 5 - HT s 3 a H © , at i » “85 4 i Py i i 5 2 3 . i ° Eo ° 3 i 2 on e i ° F Sf . g og 4 “ 2 i p. Pea Q ' a : B 8 5 8 | | t be 2 © 3 8 a 2g o 3 i a ot 8 ae ° ° o 63 o 8 | 9 P Pp | a i a a a q2 | e aj P a 8 i 3 3 oon eo €— f— & &£ | é ga | ; fc $ a 6s fi | Ga ; i 2 2 2g  g ) ° + 8 £36 i * 3 3 A q 2 § a ~~ oma i Fs > =e a = Eg r é g 4 d 4 g i 8 , &§ Fe 3 3 g 2 $ i 8 3 3 z E ad EZ E g i 5: 4 fc) a 2 Z A
MADIGAN GENERAL HOSPITAL — rm 55 D H MEDICAL DEPAEBTMENT, U.S. ABMY ‘ < i (Revised May 31, 1939) . INITIAL SUMMARY, WORKING DIAGNOSIS, CONTEMPLATED LABORATORY TESTS, AND CONSULTATIONS | Name... Mall, bor ae Grade -.......------- Puja. Ward... 2 2A Nene ctretrrcessesscss2rsss5 2222S SF SIE SS SSSA TIS IT ISS TOSI TEY BIDET TITIES TSO CCT eT CTO a ET ETE { ‘Transfer diagnosis: . gat : | Initial summary: Fainted in 1941 and 1943 and once while in the arny. Neurological examination is negative. - Cot : > | | | ' t ‘ i. . , | Working diagnosis or impression: Syncops, cause undetermined | Contemplated laboratory tests and special examinations: ° | | ; ' i 16-15817 (over) CY ME EE TOE HW 54756 Docld: 32262166 Page 27.
HALL, LORANE, = PVT oe 22a/5. 11 Mar 47! Ee ett tttetebtt htatethheteteieteimraert] ee LEI Kalitta cach Seether ere eee eee ee ee AR nL STS paeiahytyphenete-tpiedyhpitedehetebeteieneienriohetrin earn E EES EEE aTnnt Lett Ser ere Petre ee eS tet el el! White male, age 17, with one mohth military service, entered the i hospital relating that in 1941 after he had been in a hospital for fever, he had fainted while in a formation while standing in the sun, He denies any convulsions. Patient just passes out and comes to in a few minutes. Later that same year, while standing at inspection for the. Civil Aeronautic Patrol, he just fainted. He believes that he was very weak from not having eaten dinner. While in the army in a dayroom he was getting up out of a chair, hit is back against the arm of the i chair, felt a pain go up to his head and then just passed out. Patient was admitted to the hospital. Neurological examination of patient is completely negative. Patient appears somewhat immature, Lumbar puncture, spinal fluid analysis, X-ray of skull, glucose tolerance curve, and other routine laboratory tests were completely normal. We are unable to substantiate any diagnosis of epilepsy; however, it is felt that this patient should be separated from the service with the diagnesss of syncope, cause undetermined, Patient may be returned to civilian life essentially in the same condition as on entrance in the army. He will be discharged me ision of JAR 615-365. | IP, queer ee eee ee eee eee ence ene ene en mee nant snore nner ee neennnnmeenansmmennnennnn nana anes sane ane emmmmn wee mem mete ARR ROG SRG RRAE ROS ROS OA OO CBG GTS SS Oe een nnn nn nn nn ee en nee eee ae 36-18817 2S "ve H¥ 54756 Docld:32262166 Page 28
‘ rm 55 Mepicat. DEPARTMENT, U.8, ARMY _Cievised Nuy 31, 1030) i | r crabs (Complications and changes in diagnosis, with date in cach case, should be entered on this shect) Lofch -+7 , Pong Dh bh poh me ah Rel Gaue frac 1ackexed ay 4 by desot ¢ etane “4 Legg fle amet es icaret a ee Po ee ph honed LU iyty th (iy, MCORP. 3 28 Feb 47: Patient has had no observed faints or convulsions while in the hospital, X-ray of skull, lumbar puncture and spinal fluid analysis, glucose tolerance curve, and other routine laborato have 411 been negative, os . ; \/ { Je H H | { | 1l Mar 47: Interview with patient's mother yesterday reveds that patient 1 | | i ' ‘ eh eteteewceenee en has-had no convulsions to her knowledge. Patient did have a faint while standing in a formation in a Civil Aeronautic Patrol, Patient's mother recalled no history of epilepsy in the family. It is felt that patient : should be separated from the army with the impression of syncope, cause : ngsis of epilepsy? undetermined, We are unable to substantia re L. PL ddnk/ (Use both sides of this sheet) off 16-—18818
A Co ane enn ere arses ao + a pereeeenres ote re i Sn one arn ce cee nnn han nn en nnn 8 ne see eee een een en cnn cnnneeecdencnn econ eee OE LE OS ES SRE RNS LSS LS COSMOS L SPSS LSS HASSE EN SERS SESS SHAS See eee eeRe Se Mean ES Eee See TE ee Ee Beart & hunes are negative 43 MAR 1945 . Oe " a -M.C. ee WO AGO FORM B63 fyrlesse WRney bowed,” - RADIOLOGIC REPORT ¢ a . fs raemebn reget mes ee ewan} NAME : . GRADE SERIAL No. AGE WARD Hall Lak aw _E. fer 1722 445 12 pak PART TO BE EXAMINED (OR TREATED) Ap and lateral films of he skull show no bony pathology. | , a COL. MC w wt { Film No. ....--.-.----eesse-eoon- Date 2/24/47 wecence cnc n wen enn aceecnnennnnnnnnnenecnnenncnnceceecnvance ; M.C, of 7 | LMA atl 8-63 SMR AMDFomSk2 RADIOLOGIC REPORT 38 Ct
Form 551L ay ree Urea ti 3. ARMY oon d May 31, 1939) | | LABORATORY REPORTS ‘ ' 4 in = dee _Hall,..LY ran. aeape Es Serial nadaaatttonis A che gael. Lal: KAS, D.. “Ward | | | «xa Halle / | | | | | xamina’ hsted by -d~ 20d. on veeeeiny Mi CL Examination re y (indicate ion requested by y chock wr bio First |__ een aoe a) env mncunes| > youn becreeneusennesnnn Second ry in eel ay 2 a i irda fg J OL nf AIO n anne] mepen tne Fourth ff -L [SSA RenNenne Aas “Somme tresses - Mao SERIE eae aR Date Somat , BLOOD ) (Chemistry) M DeaneNt, U U. 8, ARM EP. , OTe vised June 0, 1942) ¥ ard 16188831 Date wt! ete ht ee Sle ee . : fa . . 55 ; 7 r 1 SET aS yess Sha FLUDD Date 0 au poor Rew PY i 7, see tau 19042, which may bowed ua | : : 16—32176-3 x aro ; + 26—16980-2 __ existing stocks are exhausted “(Old W.D., M. D. Form No. 551-5, “ORIN A I iY 9 Juno 1942) GPo ie-10000-3 HE_5A256. Dold s522G2 166 meh Oe—al
“" N FI uo nee « . 7 wen . rm 56 E-1 ’, ‘ | : CONSULTATION REQUEST AND REPORT (ufedh: iby | nme ad, A.vbacn.L Grade -—_. = tL in ie Kah ee ny 19.2 To Chief of enn Servic, | TO a neeee en ennenenenenn ene ceeneeegecnesesneceeecaceneeeereoeenerecee Approved. For consultation, Disapproved. . Date ....3.0-—Marre bye » 194.7. Opinion of consultant: The subject attained a-Full Score of 111 on the “echsler- Lelievue intellipence test, giving him an I.Q. of 110 and placing him in the AVERAGE classification. The subject shows 11.3% mental deterioration, where the norm for his age group is 0%. His psychometric pattern is in.general that of a psychopath: the perforwance: scope is greater than the ver- al score; the sum of the object assembly and picture arrange ment scores is greater then that of the block design and Picture completion scores; the picture arrangement score is abnormally high; the digit symbol score is the lowest of the performance scores. Negative signs: great intertest variabiltiy; very poor performence on digits backwards in a person of otherwise averase mentality,.This last sign is usually in- i | H OE. , 19..... Date 22020 ----n-seneennnnewencnnneesnnneceene , 19.2... | Office, Chief of oe anene ene Service. | Office, Chief of —_..--.------eneeveaee teeecennee Service. | i | | | | dicative of some organic impairment. ‘ Wiba eam I i rrr MET Lorn ey ennLe ley pf on a-a- | . psychietric sociel’worke¥ ¢ 29 (ove) teagan ° te ee ee renee eeecomecnee. e
. *REQUIRED , = vate Oy hater Race ONLY WHEN DIAGNOSIS A j STENCIL PROCEDURE 1S USED pir Cas Prop Sta Ft Lewis,Wn INSTRUCTIONS: Original of INITIAL REPORT must be forwarded to Registrar by { 1200 of the day following admission. File duplicate copy with clinical record. Answer all items, The information need only be tentative, but should be as correct as possible. A CORRECTED REPORT will be submitted without delay when any information sub- mitted on the inilial report is found to be incorrect, as in a change of diagnosis. AN ADDITIONAL REPORT, will be submitted when supplemental information (including additional diagnoses) becomes available or when a condition is cured. Me F 4 - 12, PL. ~ 13. WARD No. £07, 7) (> el hE an 14. TYPE OF REPORT (Check one) ( APE OF PATIENT (Check one) ’ (Chowria, Cl correcren CJ appirionat PJsta.nosp. [] Re. hosp. heen, HOSP, f 16. SPECIALTY (Check one) GENERAL MEDICINE NEUROSURGERY L | TROPICAL DISEASES GEN & ORTH SURGERY |cLosepwarDNP | OPHTHALMOLOGIC SURGERY OPEN WARD NP [vascuuar surcery | TRENCH FOOT THORACIC SURGERY . | _[rusercucss | FEMALE . ~ PLAST & MAX-FAC SUR a PW OFFICER De | [neurosvenws | ewem = BLIND yee tp AMPUTEE |" NEUROLOGY 7 17, PROBABLE DISPOSITION (Check one) IN APPROXIMATELY DAYS Clruu purty (2D uimireo bury C) retirement [Jepp toown care (J) TRANSFER TOVAF [_] TRANSFER TO OTHER HOSPITAL 18, HOSPITAL RECORDS REQUESTED (For probable CDD, record all previous hospitalization in U. 8. Do not | tnelude records on ward.) HOSPITAL DATE OF HOSPITALIZATION Wo eo 8-176 go
DATE NURSING NOTES mp 22043 4 : | — |< TES AND EATMENT cORD DATE DISCON- TINUED 1 DEL. tas uL2o oe alSTER NO. “O#47 = 7 | AT THE ENO OF EACH PERIOD ON DUTY NURSE WILL PLACE CHECK MARK IN PROPER COL COMPLETED AND WILL ENTER RER LAST INITIALON BOTTOM LINE AS CERTIFICATION TH. BEER COMPLETED, DATE OF ADMISSION, GRADE ARNY SERIAL NUMBER ~ Tt : ™ ee a y . tose . Pvt LYS BE Ha} 7 atl POY Se a Cber. G2 ori a keane * OW ™ . had etre ew * . - pe Pata agri ms PTET Ree EI TE Ly TECPEL PUTT ETT DIAGNOSIS
> a“ so, HW 547.56. . ' ? . DO NOT USE CODE BOXES i. Lasr Nau, Fiast Nase, Mibpte INITIAL Al A2 A3 Hall Loran E — _— ° 2. Recister No. 3. Army Sexiat No. 4. Grave Bl B2 B3 | 17224450 Pvt 5. ORGANIZATION ANDANM On SERVICE (iF AAF personnel, sec below)* | Ci c2 Co 1) 130_ ; . | & Ace | 7 Rack” 18, Lenora oF Sunvice).9, Date op Apuission | DI D2 | D3 ~ » | 17 Wi 1-12 20 Jan 47 ; 10. Source or Apmission } : : El E2 E3 Ry ° *If AAF, indicate pilot, non-pilot flying pers., ground pers., or avn. cadet F "1 1. Cause or Avmission, ADDIFIONAL Diacnroszs, Operations, CHANGE or Status . : é (q Tine oF Dury —- — s > B ‘ “| 13. Disposrmon . T . U 14, Date or Disrosrrion 15. Days Lost-> | Torau Hosprrat Quaarras , vi] Wa 16. Nauk anp Location of Rgurogrinc INSTALLATION ” “Wl | wa . : ‘T?. Sicratune W.D..A.G. 0. FORM NO.8-24 ; 1 July 1944 °. (This form supersedes W. D. M.D. Form No. 52 ai<2 which wiil not bo used after receipt of this revision.) <4 16—40804-1  v apo gv 4 ' . . Mos . 2 ‘ qd - > > 's ° S . . a : ©. -- DoctId: 32262166 . Page 35,: Les _ foe aa - coe ate > ° L t . a * ’ : ; : c ~ "G4 ray . t . ¢ . ° ig ' . ‘ ee aa . “OY +e . , e ° . an a ¥ o ‘ ° ‘ . s o. ) oe og ten . ay ° x . s a o : 3 0 « mn Cay 3 , ” ro . a e ‘ ‘ ‘ oan * 3 ° “ ‘ é e ro ge 2 ee oS £ “et 4 ’ ~? Q toe fa » > 2 ‘ . ' ‘ ° add e * a> . wow ' ‘ a y
Docld:32262166 Page 36. = ic, Faust Name, Mivpes [nina Loran  ‘E 3. Anmy Serrat No. 4. Grape BL B2 B3 17 224 450 Pvt BY Gucanizayion anv Agni on Sunuvicr (if AAF personnel, see below)* | Ci C2 (Unasgd) Co D 13@th Tng Bn | 6 Ace | 7. [Race |G, LencritovSeuvictk| 9, Dave or Apmission | DI D2 bs 18 Feb 47 1. .Disease, undiagnosed, manifested by Syncope « 21 Feb 47: (9172-023) Lumbar puncture, spinal fluid negative. Specialized Treatment: Gen Médicine = [s——— Reconditioning Class: 3A - a, R Ta ise bh > 1-No ETS 13. Disrosizton : Tv Duty, Timited service due to dg 1 9 Apr 47 , re , 14 Dare or Disrosrrox ‘15. Days Los: Toran Hospital QuantTEus | 50 50 vi) v2" 16. Namuz anp Location oy Reroatinc INsTALLaTIoN Madigan; General Hospital, Tacoma, Wach, [Wi [wr 17, Sicnaturk C. R. GELLINGHAM, Major, MAC Ce? WDA 0: (This form supersedes W. D.- Form No. 62, which will not be used after recsipt ‘of this 4 Bee __.d6-—40864-1 1X GPO)
4 | REGISTER OF DENTAL PATIENTS AT ni oir NTAL CLINIC, DC-1 (B) mM SURNAME “ (2) CHRISTIAN NAME | ' "¢3) RANK’ (4) COMPANY {S) REGIMENT OR STAFF CORPS : oe . CG) AGE, YEARS (7) RACE (8) NATIVITY (9) savicg, YEARS “‘NOILVIOF ‘OLS ‘BvISNoOAS HLIM ANNACNI XO aSvasIa0 (OL) “SNOILVOMIANOD {te a (md bed fe] a uv mm a > 4 o z o = ro c > a m a > r4 og 2 > 4 G 2 a i+) a 4 a il > a4 4 fl z 4 a OL 18 SYUVNAYN ONY SLINSIY CzE) w. G. 2 Form No. 8-116 Wi PWD M.D. Ferm No. 79, which may Montinue in use) 31 May 1944 FY
*REPORT OF DENTAL SURVEY \ UPPER TEETH sins tasede 7 8 ner ion LOWER TEETH Occlusion. : Calculus: Slight, Medium, Heavy - Periodontoclasi Dental foci suspected: Yes * No Other cone , : Major. 9 “#Restorable cafious tee Nonrestorable carious teeth by / Missing natural, feeth | by X Teeth: veplace’, by, de ure o (horizontal Tine), 1 Teeth replaced ‘by “fixed bridge (oval't td, include, abutinents)
° Sac cc SSS 25 bay 1945 -ggs2 S8U-Sco MAGH 251 VADICAD Gaal HOSPITAL i 26 Nov 46) Tacora,‘fasi:inton Ward & 28/5 . mS Date 21 Mar 47 . ; jos Hosp. Reg. No. 80 487 | ‘ , AB 615-365 | ee Request for TD Proceedih;, for: _. rT. Name 2.4.3. N.S. Grade 4. Orvanization, and Ara : or 3rarnch oo | Ft. Lewis, a | HALL, Lomas e, | 324 490 Fv (Gnaaged) Co 2 139 Tae Ba 5. Color “19, Diagnosis ! 6. Date of admission i Syncape, causo undetormined 19 Feb 47 0 —_—-—__--— Previous hospitalization at: | Date of: Previous hos: nitalization at: ate of: t | —— [previous Woesitaibaation een Le net mee ae ee 8 ee pee ae te Previous hosoitalization at: | ete of: Previous hos jitalization at: | | a i Note: Use back to recon oid] Barthes nn (ae A Veterans or home care} L. ¥. dazk,/ist Ut., Mo ee Nome or Stamp of “iard Officer “Dave of:
ica a, Hosritan . 44, Last Name, First Name, Muppg INITIAL NE «6©j250th ied Sta Hosp HALL,Loran & ; b. Warp ec. REUGION | d. Prey. Avy. 2, REGISTER No; 3, ARMY SzRaL No. 4, Guape ee ke Cath | no | 17° 287 [17 224 450 | Ret @. NAME AND ADDRESS OF NEAREST Reiative| 5. ORGANIZATION AND Ans OR Service (if AAF personnel, see below)*® Mother: Marie INF, Hq Trp 6th Const Regt 126 1/ 2 West Sixth ¢. Acs |7. Race | 8, LenornorSenvice| 0. DATE OF ADuIssION Newton, Kansas 1s |W jl 6/12 26 Nov 48 f. Dis, | Ing B.C lg, Apsitzind Crricen| 10. Source OF ADMISSION . | OLd Disp 6th Const * Y AAF, Indicate pilot, non-pilot Mylng personnel, ground personnel or-aviation cadet. 11, Finat Dracnosis, ADDITIONAL DIAGNOSES, OPERATIONS, Cuanog or Starua Adm Diag: Hepatitis, obs for | PROFILE SERIAL P U i ob H ‘E 8 x R Dp ee NY spectre . Last (if known) er | eee | ne | er | PRESENT 12, Ling or Duty : 13, Disrositon aND Dats 14, SIGNATURE OF WaBD SURGEON . ode, = | SE Dr Ptr Cop blue, | Replaces WD AGO Form 8-33, 1 Jul44and WD AGL (31 5-48 4006-12034 -3505 MD Form 53A, 31 May 39, which are obsolete, WO AGO Form 8-33 . ‘ gk U.S. GOVERNMENT PRINTING OFFICER —16—-40778-1 1 APR 1048 . i BP. i ed ee eo ae
Py baal * ¢@ ry . Form 55 B iy i MepicaL DEPARTMENT, U. 8. ARMY sy bd . (Revised May 31, 1939) CHIEF COMPLAINT—CONDITION ON ADMISSION—PREVIOUS PERSONAL HISTORY Chief complaint; : o- 1 dte. { \eahrnceds, ruabecer YU dusriglch — / , wy, Ly = tho flashed fiers - flaw, | ' i | i t ' | Gencral app nee and condition on admission: H t t H 1 | UIA, wn, 0 19 yr otk 7? i eo acute dustin t c0- gushes . Occupation: Buyer | Tropical service: Habits (alcohol, tobacco, drugs): S-6 hese dochy y 4 ) ek Family history: 7 pave ta CH dll, the, peak lh Previous personal history: SV¢6 | waa LA gee Eatfee Padi sb he we a fr ‘ HW 54756 DBocld:32262166 Page 42 39
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« ° : , 4 e s “ Form 55 C-1 ; aon Mepicat DaraRtMent, U.8. ABMY . : : te May 31, 1939) . I» ° , PHYSICAL EXAMINATION - . Height: , Normal weight: , Present weight: | 1 Skin: Ly gir. WO ee Le ahh. gd re oe i i Head (including special senses, nose, mouth, throat, and pharynx): ‘ « ' > _ Rib. Wn pctius | . Lungs: Maciek Vascular system (arterial and venous): | Pla rentenit Blood pressure: Systolic ww LAS meewncesennnennens 3 dlastolio  . _ Heart: Pewee ewewew arene eee ene. 5 Re ee RE ee eee owe e =m sree eee ee oe et Oe ee ORR ene neeenmenen csc ercenncence cee won Y { (oven) oi oo "masse WY9SZ58. -DocTdg2262166_ Page 44
— ae — <a, . i a sade piteg mer eee ese ~ ae me ee ae -+ . - § - ‘O° | ; ~ k i 2 , 3 , i ; Je 5 3 # Fl “ g N\ S44 , a Ne ey 3 aN Ni : Hl nemmnnneenaewansainewreennnennceceece een eee scene en nee nee eneen ne nec. . : men ewn enn e mere conn nn en nnee tenn nnnweweewennnenenn nucecceceecesecnnsnweene coe eecnesenecenwceecenene senna nmmneeeneen 7
WD AGO FORM 8-51 . MAR. 1945 (ola WD Me Form 55¥, 31 May 1939, which may be usod w ntil existing stocks are oxhaus usted.) -PROGRESS NOTES i ni. | Sannin ombe-tt Dene Dl oie te Eee PSTSSS IS SSsssSssssssssssscssesssse Papasan ucasceeen stun ipso anon etaeeoooocaneaeeeeentoes (Complications and changes in diagnosis, with date in each. case, should be entered on this sheet) 37 Yo. Cb ae Baile Dt lle’ | atte state pa 7 is Cy a oa = Ia wo 8 et | fe aed . SF ({- fap 4 a) ; ‘tf was sae cad Ze dpa Ha aH acide | H (Use both sides of, this sheet) { I _ 10-18918-1 HW 54756 Docld: we 62166 Ea Sth ®.-- peat, a aaeieg Aabie Sta o-oo oie Nan tah ts ie eee si eel
HEALLIG —, Form 55 Q-1 | Mapioaz Darastunn 0.8. 8. AEMY (Revised May 31, 1 i “TREATMENT eLeesourd at ae oe 6" ’ . ~~. £6. whe SAI Cas ees LATIN - . S. ra ras we
ee Ee ee See See ern ee eee eet ete eee DD Daa a TaD a a ald Selah atatatalata lalate datataatatatatentes wee ee ee tween ee em meena cere c me mere eres en nee cenceer cess erecsesscaseenewes (Over) Ward 2... ae, Medication and Nurse’s Notes —TREATMENT—NURSE’S NOTES j : x | . : re ee es Se Cae ; 3 J 4 of en . . po . ; oe oe a fb | een | ees / oo oe LE IS || ttf SESSHRSRRRRAERE Ka Ll ee — a: es eee SS ee | poor ot SS eee cae ce) eee ane - Scere : ps Giefaist [TET Tt TT. «! » ' =i ye se ele CE 28 (eS : te ag ; & so ay ; i 2 ~~ i Z z3 Jig {4d a! @ OP AUaA AA TEE LEE EEE i 7 e e : / ° . S an ; m ee E
i i} vi ° rm 55 He ‘s H | Name. Wo8k, ‘Rororn.. Grade Rede... Ward = 2 } Date Wt Medication and Nurse's Notes H avr |PIR +  R | H ‘a: Bolo! W4Zolad | ct me. i260 @. t . , ‘ + mee ~. - . 7 2 , ~ i H hou G aay aa bes Aas |e WO aad . e i pat LRA SA ug : i . H i H t Ase g © am . 3a *. f DLE aa lone] hd S4756 Docldi 322627166 Page 49 gegen ene ee ie ne re er rene cn weer ee
q7 HW 54756 en ren nee es eee een nee nen rene = en 5H ann ern ne nearer ETRE Tere etm nn sen ee Meena ene een ce em wen a come cernnas asec csewe cee Form 865 K-1 ' © Meping DEPARTMENT, U. 8. ARMY . . vised May 31, 1939) . RADIOLOGIC RECORD Name Hose 9 Lowe we SE. Grade. (Rete. Wed 2 HOSPITAL / SIGNATURE | Film No. A070... Date we Dec 48 D.P. vabbitt, Caype, WD AGO Form . op ree is 8463 psi wncamaybeuce.” RADIOLOGIC REPORT | ~o 9 so Moines Film No. .._/- S728: — Date p- Dee-pQennn--e-venneveeee-- FORM } ‘ yea ttae OH-GS  Replegs WOMD xomosK-2 RADIOLOGIC REPORT a ae we cro tt, Cant... af.C. 16-42737-2 W% GPO oe toes 8-63 Petes MEME Foraea” RADIOLOGIC REPORT 7-50 M-12655 Qory Doc kd :3226216 Page 50. oe Nps oo iad aie Sager irene se ee arene eo a ae TF ee ewe etcwes rows con mamma eennaes samen meee conn n i eee ence emncn oe were nena ener
a ° Form 551 : MEDICAL DePanTMENT, U.S. ARMY . (Revised May 31, 1939) annenwcenneeezanennn ’ Ward = Aree ten ner ee ene ene ce ee! URIN 16—16974-1 Vail y = : ~.oee"| ta f | oa Ss 16—16009-3 12193 W.D.. M.D. Form No. &5 9 June 1942) a eopcptgntcecennenee ; - “Occult blood . ff ae Ee cece BiLO ceeeeegeneceeeeecannecenamncenenemtmnsinetene | : Mucus .--.---~.-—------+-+-- 200° dhiperecenennes a PUB coc ntncen en enn nen cnee enn gennrereneneneennctna panes sshd indigested food a ees a 2 <. Hs. 7 4 ROR AMA, ----nnnnnannnonsecezeraren> F enneececeerensnenenceenecnsnennanechfifion iatahhenmmabiabael teem rows oa penececcesneenunctunnsenncoeesens one aemewecom ee nanecolecnansnenecnercentecencneeeeehi ST Tura os poneeceneennenenene f. Remarks: cnet eeceenncntnenernnn . B aeepacceeetnenrnntneentenacneetfennene ae aan 3 + ' . . [ Lab. weeme ewer nee U i - eawenrntorsssceewacesesemwensamnwscnmsermeer nes, wuteenenoe t H 5}. Mxpicat DapantMEn?, U. 8. A . FECES Da tet? Let GAG eanonens ! (Revised June 9, 1942) | apo 16—16973-1 j : we Gaerled Tame 91043) Ap o 6 FECES Date .©” cdhee , let an oO aro BS: ' ‘ “9 Jane 3042) ~ : : ee | can COM 55 LB i se M. C. | Mapican Deranranr, U 8. Ane { bd hemis De Ate -cnncecennne! adn coronene .! tL (Rovised Juno 9, 1942) [koro 10-10 10-—-10083-1 : it , worm BB ra " BLOOD (Chemistry) \ _ Mgpwat vised Fane be k oro 19—10000-1 (en —_ _ | | Mxpican Duranruxne, U. 8. ABMY | GasT ER Qrstyais Date : Lf Hod SL fd / Ae (Revised June 9, 1942) ' ean Seat tern en css ancwunens seuss ceree 0 opa— 1616972-S
wt Form 56 0-2 MEDICAL DEPARTMENT, U. S. ARMY * (Revised May 31, 1939) i , . IPERATION REPORT Name _Hatl, Loran nuntunee S semnenennnnene . a ReGe War decennn Decne Age... +8 d Rege-No: 1/287 Postoperative diagnosis: Pigmented naevi, |} i ; Operation: Excision oY naevi | 4 ion of the operative site the areas sur-| —+; e infiltrated with 1 % procaine. ‘the t ing longitudinal ellipteal incision. 1 trolled by pressure and the skin su~ Remarks: After preparat rounding the naevi w¢ naevi were excised ug The hemorrhage was cq tured (No 4 silk). Operation vegan nc numtllaes setnninnnenmnnntanns SOT Operator _._. Gapt. E Babbitt i seventeen seze w enectennsntemaninnmtnretins cnn Assistants __, Capt. se H enderdpn irinuinpnnninininininenieneninnnmnnnininininenmnnninnetinninntietininiatiibsiusnamisininiie . Anesthesia used,,,...22...2., Procad! he sn euantnseannasigngeamncsesns ATONE cannes \ lt Anesthetist _ OPCTE COE nl Naevi X 2 44 AW .24756 “Sip A.G. M.BS, 12-43 40.000
q, . _ HBADQUARTURS 250th HEDICAL APAT([oN HOSPITAL REGENSBUFG UPGTaAny Post — APO 225 US ARMY cna SUBJECT: Hospital Clearance ¢d to have the following form init- and upon completion, this form will trar. 1. You are request ialed by those indicate be turned in to the Regils 2. Until this form/is completed you will not be dis- charged from this hospital. © ae NAME INITIALS WARD OFFICER ESS=SPRIEE LIBRARY SPECIAL SERVICE | REGISTRAR 50 aes HW 54756 Docld:32262166 Page 53.0. +i perrwrerr ee om ST TR oe =e ET se . .  Peeae 5
we, | *- ase ~“ ‘ ‘ CLINICAL RECORD a. Hosritan | 1, Last NAME, Finst NAME, MIDDLE INITIAL ‘ i "BRIEF Sesth Sta Hosp HALL, LORAN E . b. Warp ec. Reuaion | d.fiesv. Apw. | 2. Reaister No. RAsar Seniat No. 4. Grapg . é ; S=2 C Ih 35714 17 224 450 Pvt @. NAME AND ADDRESS OF NEARHSE RELATIVE] 5. ORGANIZATI R SERVICE (if AAF porsonnel, seo below)" MsMarie Hall | 97 Const Signal Sqd,APO 154(4) 1263 West 6 St : 6. Ace [7 Race | 8 LeNnormor Szavicg| 9. )A BaLlSBION Newton, Kansaal}. 20 W 1188/12 +116 Sept 46 f. Dis._| Iss. | B/C |g. Avsrtpike Orricer Dineesabasnal proper s tation I FB/t 97 Const Sig Sqd,Stuttgart, (2| . i AAF, indicate pilot, non-pi 4 flying personnel, ground personnel or aviation cadet. 1, Finat DiaAGNosis, AvpITIg) NAL DIAGNOSES, OPERATIONS, Caanos oF Status , , : “On (a) DSs 7715 MWlOLD Sig Scncol, Aasbach, Geraany, APO 96 ° (ey Germany | cs + > Wound, contuged, back, lumbo-sacral region, acute, mild.ji| | . aeie at about 1430 hours on 16 September 1948 at the Kaserrie¢ Ansbach, Germany, when patient while on dutyl|was playing. in an authorized foote ball game whem he fell upon another players knee, _ PROFILE P voli ' i enemas | cinemas | amen || nee | nn | StS ‘ Last (if kaown) PRESENT . Hi 12. Ling oy Duty 13. Disddsyrion AND Dats 14, SIGNATURE OF WARD SURGEON — HERBERT MUNHALL CAPT.MC, GO FoRM YOu. &. GOVERNMENT HRINTING OFFICE = 16—40778-1 Replaces WD AGO Form 8-33, 1 Jul 44and WD Har a 8-33 MD Form 853A, 31 May 39, which are obsolete. Paver 19g ty HW 54756 Docld:32262166 Page 54
' TEMPERATURE—THEA pasneit NURSES NOTES | Bare Medication and Nurse’s Notes aval wnbau) goat “He - z Er ot 2 nw ee
Uo ee ‘ wore Form 65 A-1 0 ‘| Maproan DEPARTMENT, U. 8. Army ABB Re / (Authorized Dec. 81, 1942) . - ATED CLINICAL RECORD open ag ha hag, Oye oh Pe ERAS 1388 th Station Hospital | Wheat heute Hantane =, «, exe APO 698, Nurnberg, Germany oot : | fee oe Piet MME weet mene eee gage eae tem hnetion with 55A, M.D. in cases where the data hereon will | ppulations.)"--- op a 4 Pertinent history, chief complgint, and condition on admission. - | L ob fret suffice to conform with existing Hi | | (This sheet to be used in cor i { | (Use both sides of this sheet) 16—82780-1 es | es ae sere teen cen ee en ee ae ene peewee.
na ty | lou Z { jill Form 55 Hel ; H Muapmat Dz: Deramete Nt, U. 8, ARMY | ya (Revised May al, 1939) a 4 TEMPERATURE+fREATMENT—NURSE’S NOTES. Name _2va9s tonsil! bo Grade rt Ward Sa | i i Medication and Nurse's Notes al ~ eat tox ht, @ 14 22 pe f Pe VitAY a PADS . EAA | fiir i _ 16 ~ 19396-1 ~~ (Over)
DO ROT USE CODE BOXES 1, Last Name, First Name, Minbhe initia . Al A2 A3 Eran nae ot, % Recisrea No. | § uy Seah No. 4 Guape | Bl) B21 B3 35714 117 284 450 | Pvt INJaND Ana on SERY : ary AAF personnel, ece below)* | Ci ‘orth Const Sig}$ad (a) 6. Ace [7 Race beast 7 Ve Sent aa ‘DI | 2 20_| W f-8/1%|| 16 Sept 48 § 610. Source or Apuissron J) -casua pepper station BuUCOM (b) “If AAF, indicate pilot, non-pilo a & pers., ground pers., or avn. cadet 11. Cause oF Avsission, App: liz Diacnoszs, Oprrations, Cuance or Status (a) DS: 7718 BUKOM Sie School (b) Sig SchooljHnsbach, Germany ‘Wound, contused| lback, lumbo-., sacral region, §igute, "mild. A.t. at about 450 hours on 16 Sept 1948, alt the Kaserne in Ansbach, Gepmany, when na- tient while onjiduty wae playing in an authorized Pootbell game when he fell u olayers knee, 12, Ling or Durr Ye 3 13. Disposirion Duty »ee Hra 1 service : ih 14. Dare o¢ Dispostrion lo ents 7 ber 19 48 15. Days Losr=> | Toran - lie Hosrrray | Quarrzns 2 16. Name anp Locanign on. Rep ons cae | APO GC, | Hl WA 2 “Germany «This Fai onan capann Ww. D. which will not be used after ii 17, Stcnaturs FRITZ iHM, ee egistrar Form No. he ‘of this revision 5 ST H—10080-1 tt oro
‘TT, Sienatvan r fadhs. hi DO NOT USE Conk noxeEs 1. Last Nag, Finst Nase, Mippis Inrriah \ A3 Hf. of RGISTER N6 } Anwy Sinan No. 4. Gaape — commer C2211 $O_| Pel 5. OnGANrZzaTION AN MOB SeRvicE (if AAF personnel, see below)* | Cl Se ao Pek ENCTH OF Sznvicz| 9. Datz oy Apmussion | DI IE, YO Sounce or Apu a a, “lf AAF, indicate pl att ‘on-pilot | flying pers., ground pers., or avn. cadet il. Cause or F Aven ae. iN, ADDITIONAL DracnosEes, OPERATIONS, CHANGE AIP. Zy 13, Disrosrmo0n 14. Dare or Deron 1S. Days Losr => Hosrrran 16. Nane ann Loca ! rr Reeonmine Instactation (This form supe which will not ba i Form No. d iter “osipe ‘of this revision’) 16—40864-1 tr Po
HW 54756 1 OUIpanent ‘ 1. Last Name, Fyast Name, Miovte Intrian , 2 Rucssrss No. 73, Anmy Seal No. " 1 "95 # nD Aw OB Seavice (if AAF persoar 55 ‘ or 2 ZL Vl SY ar dt oa ? . de . ‘ ©. AcE # Fai < \Lencru ov Senvichf9 ~Dat ‘oF Avmissiun D3 , 10, Sovace or Arfission is ES “If AAF, indica blow non-pitot flying pers. ground pers., or avo. cadet 31, Cause or Apeission, AvpitionaL Diacnoses, Orxuations, Cisance or Status . Gin  & 3&5 Anica ~ . — 12. Line oF ail 13. Disrossmon 17, Stenatuas. r i 955 WN ed Vetacmmen | . | 1 | .- 7718 EUCOM Sig School |¥,5.aGo, | - APO 696 S-Army LJuly 1944 i This tormispbersedes W. D. M. D. Form No. 52, ; Cinch will p f be used after reooipt of this rovision.) Se 16—-40864-1 ¥ GPO - peek Abe poet ee eee » Pars -DecId:32262166 Page 61...
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HW 54756 ‘outa Pat epppidey “SEPORTS KONTROL SYMBOL MCS 87 1, LAST Dh). FIRST sale MIDDLE INITIAL _— , 2 reel: LL “3 vat for No. Loran £- 4 GRADE” ~~ 1 Ref _ 4450 i nthe if AR A ace (EAAF personnel sca balow)* ConR aL 2 wy RAC 8. ) 6 if OF SERVICE| 9. hnap nak Drags 2 ea | F/MAY.YF | DoclId: 32267166 LAX. SED a at Page 63 a 7] eg 9. DATE OF ADMISSION uy acufe, ina bacPoen he te ote ton aves Le Ya bbeto MAL both foot afte, Savar'as| Prag tunatas Onan, byes fa babes ARM 4. Cav. RegT- A P0305
HW 54756 DoclId: 3227627166 14, Date or Disro:tion . . re , eg es DO NOT USE CODE BOXES 1, Last Name, Frast Nase, tppor Initian . 2. Recisrer Ne 3. Maas Seri No. 4. GRADE L723 Ll? 224 450] Ret 5. ORGANIZATION AND ou Szavice (if AAF personnel, see below)* INF, Hq rp, 6th Con Ret 6. AcE 18. Lear or Sunvice| 9. Dare oF ADMISSION 18 26 Nov 48 7 Race W “If AAF, indicate pilot, a 1), Cause or Abmission, or Status | ae I= ” Me “ = ase ' Ie yoy ff, ao ee TOW OA ghee! 13 Tepstcea mr ule i ! FS 9, Vathoven tll : CAG ayy alper! Ta ae t 1a 12. Lane or Duty i 8 a * a ' ° : a = 13. Disrosrrion , jie OV T “op wt coral f fo) 15. Days Lost => QuaRrens Toran, | 16. Name anp Location 7, Sina? a ee il xeMaite Bee ee lees OTAG HT U aaa mene Gai REGISTRAR Tpaly todd . Form This f deg: (This form suporse ‘of this et which will not bo uso) ae T rooolpt 16—40804-2 x aro Jioye peer og meres! ee Page 64
DO NOT USE CODE BOXES Al A2 43 Hq trp 6th Const Sad 6. Ace | 7. acs = |8. Lenotu or Senvics| 9. Date ov Apmission 18 | W . . . 10. Sounce oF Apmission Pry *If AAFP, indicate pilot, no pilot flying pers., ground pers., or avn. cadet 11. Cause oF Apission, BDITIONAL Diacnosgs, Opgnations, Caance or Status - 26 No# 4 Trf.Diag: Hppatitis ,obs for |{# 400g o ChE | .! 4 | 12, Ling ov Duty 13. Disposition 14, Date or Disrowtion, } 15. Days Losr=> [ ‘Torat Hosprrat Quaarers Spa Hosp, APO 225 , Germany Wi w2 17, Sienatuae (This form supersedes! ¥ . M.D. Form No. 52, which will not be used jaftdr receipt of this rovision fo”), r0—d08ee- ® seo “e HW.54756 Docld:32262166 Page 65.  ,° «
‘ - — REPORTS CONTROL SYMBOL MCS 67 DO NOT USE CODE BOXES LAST NAME, FIRST, NAME, MIDDLE INITIAL; at) a2 * HALL, LORANT Lo 2. REGISTER Wa j Samy SERIAL No. ‘ GRADE — are B35 669 RA 17 22h 450 | Ret | 5. ORGANIZATION AND DARN OR SERVICE (if AAF personnel, see below)” {C1 =. C2 INF, "HY q TROOP 6th Gon Re&t 6. AGE [7 RACE | & ‘LENGTH OF SERVICE | 9. DATE OF ADMISSION 18 | W | 1 8/12 26 Nov 1948 10. SOURCE OF ‘0 , es © ' Direct * 11 AAF, indicate pildt, yon-pilot £ fying pe pers., § rs., ground pers., “or avn. cadet 11. ‘or status SION, ADDITIONAL DIAGNOSES, OPERATIONS, CHANGE itis, observation for. : . rl 4 26 Nov 1948 14, DATE OF DISPOSITION oo . 15. DAYS LOST—> | TOTAL , HOSPITAL | QUARTERS ; | i 46. NAME AND Loca FidN OF REPORTING “INSTALLATION ~ ~ Lisp. oth |Gon Rade, Straaoia3(2hm-so) ope NATURE «' W.D., A.G.0. FORM No. 8-24 t July 1944 ““Grhis form #1 sje sbeebdes WwW D. M. D. Form No. 52, which will not ) be sed after receipt of this revision.)
16th Co | 1. LAST NAME, st NAME, MIDDLE INITIAL Hall,Lbran FE, | 2. REGISTER No. } 3. VHOSTTED 7 | ReErE | | | | | 5. ORGANIZATION AND ARM OR SERVICE PATIENTS regt.,Hq Hq Sv Tp. 6. AGe| 7. RACE] d. LENGTH OF SERV. 9 DATE OF ADM. 18| wW 33/12 [1 Dec 48 10. SOURCE OF ADMISSION* i *Reaulred only han stencil procedure Is used. t~- — Of L-1 repO "913 ‘AVTANDAS ‘SNOIL WTNOD "NOLLYVIOT H.LIM AMNENE YO 3SVaSIC “I “Zl 8V6L snonysaso- any SINSWLV3UL JO SUNLYN NV Salva “el SoYVWIY GNY SLINS3Y
UPPER TEETH® . tat) do "43924 12345 67 8 V1 Tai LOWER TEETH® Ie. LEFT 0 te 11:10 9 9 10 111219 14 15 16 : CLASS PA Jocctusion =|} CALCULUS: SLIGHT, MEDIUM, HEAVY PERIODONTOCLAS| | DENTAL Foct sus#Et Cl ves [] no OTHER CONDITIONS OF, DENTAL OFFICER - * RESTORABLE CARI a NONRESTORABLE & MISSING cr : x ; x (xh 2)  orened TEETH REPLACED Bij (Oval to includalah ‘i lL This fi edes WD AGO F, 8-116, 31 1 WD AGO Form s form suvereedee WD AGO Form 8-116. at Af tema ieee OndHG sei erecaata Garces” wee wt Be 6s”: _ 'e—20630-2 ro
a e _ * cuimicaL Recono a. HOSPITAL 1, Last Nag, First NAME, MIDDLE Teitiad er =. |25Qth Sted Sta . Hall, Loren E e b. Ward c. Rerictcn | d. FREY 3. ARMY SERIA N 4. GRADE ° L7 228 $50 Pvt tive} 5. ORGANIZATION AND ARM OR SeRvice (if AAF porsonnel, sec below)” inf, Hq Co, 6th Arma Cav Regt ,ArO G. AGE 7. Racn | 8. LenatHor Service| 9. Datzor ADMISSION 305 19 + w | 1-8/12 | 22 Jan 49, 1100 Ins. | B/C |e. ApsaThhid 10. SOURCE OF ADMISSION WT Disp, 6th Armd * IfaaF, indicate pilot, non-pilby diving personnel, ground personnel or aviation cadet. ‘ 11. Finat Diacnosis, Avpini04 ‘DiacNoszs, OPERATIONS, CHANGE OF STATUS rs Transfer? |iNpilepsy, obs for - Diagnosis||¢onfirmed 7 hi {]: ae ae PROFILE ° P SERIAL a ' Last ‘ . (if known) . PRESENT 12, Ling or Duty 14. SIGNATUR ii WanD Replaces WD AGO Form 8 We pRinvine oFFice #407781 -33, 1Jul4gand WD FORM .S. wo AGO | 45 8-33 x ous. seven Wiehe -100M-12034-330b MD Form 584, 31 May 39, which are obsolete. bo GIADA . a
apt, | a qr i 3 : A . ‘ ‘ DO ihe : ; , | W-D.) AG. 0. FormNo.8-84 ABBREVIATED CLINICAL RECORD (Old W. D., a, Porm No. §5A-1, HM ' ; . 31 December 1942) suffice to conform with existing régitlations. ) | | Name (2 Lp Lorene 4 —____—_—- Grade Or Ward \J l | (This sheet to be used in con, — with 55A, M.D. in cases where the data hereon will rT 3 ints and condition on admission. t I : { rh 4). . ee ere nn nen en ane nnn ne ewe. Ai: an ag Va Be Fer ai Ve. ! ' } . f 4 ‘ | oan It Hse both sides of this sheet) - 16—-a2789—2 rs
Form 65 B ' Hl | MeEpical DepartMeENT, U.S. ARMY H (Revised May 31, 1939) ‘ 1 Chief complaint: Occupation: Soldier : Tropical service: i None Habits (alcohol, tobacco, drugs): Family history: General appearance and condition on ai Patient is a robust galdier of about stated age of 19 who appeers well and in no distress. CHIEF COMPLAI CONDITION ON ADMISSION—PREVIOUS 7 | PERSONAL HISTORY _ Gr ade Plack out spells and|/headaches - 4 days ission: 5 or 6 beers per day| previously ,none in last two months One package of cigarettes per day - Mother and father living and well No history of serioug family diseases Previous personal history: Usual childhood dise I Appendectomy in 1820)iwi thous complications ‘ No serious diseases #r ‘Injuries: Hit back of left 2 hrs or so end had | Back injury in Feb. ; Venereal disease: ' ' ! t rT H ! ' ' ear with basevall bat 8 mo. ago, unconscious imesia for adout one day ays in fracture. GC. at ege 14, was trpated with sulfa and had no recurrence. LF (ovER) 16—-18NI 8-1 NW_54756  Docld: 32262166 Page 71
| q sli { i HISTORY OF ' HE PRESENT ILLNESS { ‘ | ee ssign to this hospital for this i Fravious discharge followed Mis. He hed been well and was boxing dla had been for some time. Four days attring with another fellow and lead. It jarred him$ a bit but Ww seconds and then he "blacked o t" and fell. He was out just momentarily and and then got up and went on to shower snd fislt OK. Then later he was sitting in the club playing cards anc hed a similar episode which lasted only momentarily. le had one episode the next day . shilé walking along. ‘hen he had} two the day oefore admission, once: while sitting in the club amd the other while just sitting around. He hes continued tp have a rether mild, constant , dull aching Reneralized heaflache. He has felt perfectly well otherwise. He states thet he wants to get out as quickly as possible since he thinksa|ihe is about to make the boxing team which will go to The aces to box next svring. — Thés is the second ad soldier in last two months, a diagnosis of gastroenter it with a team in his outfit before admission he was sp had received a blow on the he: continued to box for a
. Form 55 C+1 MEDICAL DEPARTMENT, U.S. ABMY (Revised May 31, 1939) PH Name...... Hall,..Loran. Brn PE ee SSS Se Seats ee ob bon a ee ne on on in ene eee tee eee tere ne tne ewes erecamnuecetccnenasaus ae ie Tq whot toe nos wood woe Woy abs are a ; gy 1 ’ ‘ 1 " ‘ " at 1 ' ’ ry A ‘ 4 1 ' ‘ r a t oy ¥ if ‘ ‘ 1 a 1 ’ . . 1 ‘ a 1 ‘ 1 ‘ 4 . ‘ ‘ 4 ‘ ‘ u ‘ ‘ ‘ ‘ , . ¥ " ‘ if ' 4 “ « ' i 1 ! ’ i ‘ « Y ‘ 4 ‘ 4 ‘ Height: : —T ight: .°. %,, > + Present weight: . . Skin: wares tececanecoesenanzenyc anaes sore. Q | od @ fs) 1 bo | fe) W 6c w a © wo re) be he Be P oO Ss £7) Head (including special senses, nose, nei throat, and pharynx): © i No significant abnormalities observed - except that bone : conduction hearing ig; reduced or nearly absent on the left Neck: - - Normal | { { Thorax: | ms Normal . | Lungs: — Clear to percussion aiid auscultation a“ “6 1 ° . 1 " Vascular system (arterial and venous): | |! on Normal . i H ar ‘ ; 4 \ , co Blood pressure: Systolic B88 --=fll fo nweeeee peesncennenececees 3 diastolic oe eecensuanstncurcenes ceecacacccceceseneessen ‘ Shh Beart: Ih . Normal Ait any Roy i | | po a : | . . oe 7 , x | ihn |: | . \ (ovzR) ; . 1610816 HW 54756  DocId:32262166 Page 73 0 ua eee . _.
. a ; . . a O84 . 4 2 a: eo -* -_ -_—~ . > : Le | . : a | 7 * So. ff . : a .s ‘ bs j an ‘ ob ‘ n a “f . { o ~ - - sft, n . . . ‘ ‘ n a mie; i Lone a s ee _ at t ” _ @ ‘ . 4 _ 8 : Bet m2) _ Cc. = a : apes! = i 2 a - - ~" - = = Fo rot an ok sale E Hy H ; . _& oe - Ok wee Ok oe eee at ee Bn wal £ ml Pa None 1 2166. Pa Normal externally RLY 01d “scar. Normal externally Normal sssssssssssssssrsTesesTsS Glandular system (lymphatic and.endocrine): ; > . So a 863 wee Be BB. . ay qe i 3 mL i - 3 ; , a - to 3 ET = ae 28 meet a aoe eras fe .
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Form 85 H-1 "Mon De U.S, ARMY hy (Revised May 31, 1699) | | | a F i ATMENT—NURSE'S NOTES a ||:| esa = St In| ' Medication and Nurse’s Notes he i Date Qa 2 odiolalel | aC i. Cr 1 ee _ Crrrbntatez CAC eErre iT ede pe foe Ap ehige | 'Z ad Lis Tin Spud War >. 2 ize (Coe Gel : eo todas | a 0 in ares i , Tc Lt a ich am Polat CL Ul dea h ee eae | whol lal al Ir] : ar Age ae pal Atoll Fiance, 22 Xo. | ae Geleol rate aa ns Cys - See EE, : If fatto -_ | Bal aA Nm oa aro th WAAC tee “padgrbold | CW een ta oe Ye ER | eT e mC | EEL eke —_na tes bola aan AEA Cs | TT ie eeiabel [te i CCCs | alizreed a TT Weigle t7 NEL EP alla Bl pol ice gc 7 ne L090 Jo . gale Te iP dor, aW 54756 || Docld: 32262166, _ Page 79 an ' io ie
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p OWL ENTER BEA LAST INIT! on ail Ercorsdbaeted omar — [aaron mmaee WW py Fare [Tage Ai roate| [NURSING woTeES | ——— = [ rdhend Iaiunbanbentunnantariguntannsisnenbenkonbenbuniantanbenammeesoataebertealenionententeint aiemiantomianeiet ata NL ts 0 | ieee ete ee ee ee)
—— lowe aan faty Par 58th (US) Gen, Seas) | —-—----- _ Ward _ Film No PIE + set pemmpneye | { cowwafanaesaacnaceokdeanewewseneene Film No. dre cl Hee aiterson: > The mastotidl'e. MENT, U. 5. ARMY vised May 81, 1939) Form 53 Ke1 ART, BOTH MASTOIDS ,, Mrpicart Dep tf. (Re A eN eS = San ae ae es ee a