Released under the John F. Kennedy Assassination Records Collection Act of 1997 (44 USC YIUT Hoter. DATE: 11-14-2017 JFK Assassination System Date: Identification Form SSeS Agency Information 5/27/201 AGENCY: FBI RECORD NUMBER: —124-10134-10473 REGORD SERIES: HQ AGENCY FILENUMBER:  67-494012-196 —_— SSeS Document Information ORIGINATOR: FBI FROM: KC TO: TITLE : DATE: 07/05/1974 PAGES: 4 SUBJECTS : JAMES P. HOSTY JR. DOCUMENT TYPE: PAPER, TEXTUAL DOCUMENT CLASSIFICATION: — Unclassified RESTRICTIONS: 3 CURRENT STATUS: — Redact DATE OF LASTREVIEW: 08/31/1998 OPENING CRITERIA : - INDEFINITE COMMENTS : MED RPT, INC FD-300 i vol 25 , | Docld: 32285197 Page 1 ‘
Released under the John F. Kennedy BAP OTe? Records Collection Act of 1992 (44 USC 2107 myrey- , DADRA Forkas@017 X16 /A a A a Revisl_ April 1968 ~ So General Services Administration C ( &. + Mig Bet) gunm. on Metial Recs REPORT OF MEDICAL EXAMINA\.IN ae wR EAA. 809-3 ST NAME--FIRST NAME MIDDLE NAME 2. GRADE AND COMPONENT OR POSITION 3, IDENTIFICATION NO. ost y  Sames PArR ic uf @CiLULL/AW BSHHME MEAS { ra Oe) ot fe or. RFD, city or town, State and ZIP Code) 5. PURPOSE OF EXAMINATION 6. DATE OF “ue. 74 ! ys yh i). Sl ER An Mi AL —~fUC 7 Sy CE2os |. a) . paw ee Sen) US 62 cn \ 7. SEX 8. RACE 9. TOTAL YEARS GOVERNMENT aoe 10. op 11. ORGANIZATION UNIT : Mave |e Te 12. DATE OF BIRTH 13, PLACE OF BIRTH 14, NAME. RELATIONS ND ADD) ott OF NEXT a KIN a, . Th WME = TF OS 7 ‘fh 4 : aynue 24 | cH1Es6e, are za. tt ef | | 15, EXAMINE jG FAC ity OR EXAMINER, AND ADDRESS 16, OTHER INFORMATION Seed » Ble a wei we +s PF ATINGE : tog TIME IN THIS CAPACITY (Total) LAST SIX MONTHS NOTES. (Descrite every abnormality in detail. Enter pertinent item number ‘before each comment.- ntinue in item 73 and use additional sheets if necessary.) - t t ‘ . { : i eck each item inappropriate col- ABNOR- umn, enter '‘NE"' it not evaluated. MAL 21. MOUTH AND THROAT 7 (Int. & ext. canals) (Auditorug 22. EARS—GENERAL acuily under items 70 and 71) , ay Jervsile Fuve Ca xX 23. DRUMS (Perforation) 5 H ' . (Visual acuity and refraction . . 7 w\sh¥, . i WK _|| 24. EYESGENERAL under ite items 59. 60 and 67) Cis, 2 fF pt or oR ou at f - ' Jf .: x 5. OPHT ALMOSCOPIC P22, i! vi ~ er] Ly 26. PUPILS (Equality and reaction) z a = f- , . ‘ -- . . : (Associated paraliel move- : “4 . . 4 27. OCULAR MOTILITY ments, nystagmus) “a 7k Soo, ys ' 4 28. LUNGS AND CHEST (Include breasts) i 29. HEART (Thrust, size, rhythm, sounds) | 30. VASCULAR SYSTEM (Varicosities, etc.) . : C 140 . an . ny ; S731. ABDOMEN AND VISCERA (Include hernia) ‘ , RE ° . . - es iG 32. ANUS AND RECTUM (Hemorrhoids, fistulae) || (Prostate, if indicated) 33: ENDOCRINE SYSTEM a ; bea weer ne 34. G-U SYSTEM ; 4 poste Spear 31 Tiree Ls SS (Strength, range of 35. UPPER EXTREMITIES [Oyreno ° x |_| 36. FEET i | || |? x . (Except feet) 37. LOWER EXTREM ITIES (Strength. range of motion) xix i “ | 38. SPINE, OTHER MUSCULOSKELETAL ¥ i H | 39. IDENTIFYING BODY MARKS. SCARS, TATTOOS | % s Cc aA piath-o maak fe ster toh 9D ae. «< D< | 40. SKIN, LYMPHATICS J / MC | 41, NEUROLOGIC (Equilibrium teste under item 72)| ] ') i f af ; 2c 7 7 Qned . ' TT | 42. PSYCHIATRIC (Specify any personality deviation) ve . ~ me > 4 43. PELVIC (Females only) (Check how done) . Civacina C)rectac|- ~ |: . . (Continue in item 73) . 44. DENTAL (Place appropriate symbols, shown in examples, above or below number of upper and lower er teeth.) REMARKS AND ADDITIONAL DENTAL * | ‘ ; -DEFECTS AND DISEASES - 1 0 coe : x xX : : - Non- soe Replaced Fixed 1 2. 3) Restorable 1 2.3 12.3 Missirig 4 2 : ; H Cl PTT a restorable Waa a i4 by Partial 32 i 30 teeth 3 * 40 "teeth 3 a 30 teeth x 3 x dentures ’ a. 4 dentures R —_—__ —— | . E ¢ F Chest T T LABORATORY FINDINGS: 45. URINALYSIS: A. SPECIFIC GRAVITY 46, CHEST X-RAY (Place, date, film number and result) OPIC B. ALBUMIN VAe Q C. SUGAR ti. 47, SEROLOGY (Specify test used'and result) a DU-G13 8. AS py ae | SO. OTHER TESTS g 49, BLOOD TYPE AND RH FACTOR