Released under the John F. Kennedy Assassination Records Collection Act of 1992 (44 USC 2107 Hote). DATE: 11-14-2017 JFK Assassination System Date: 5/27/201 Identification Form Agency Information AGENCY: FBI RECORD NUMBER: — 124-10134-10259 RECORD SERIES: HQ AGENCY FILENUMBER: 67-494012-97 Document Information ORIGINATOR: FBI FROM: DL TO: TITLE : DATE: 02/21/1961 PAGES: 6 SUBJECTS : JAMES P. HOSTY JR. DOCUMENT TYPE: PAPER, TEXTUAL DOCUMENT CLASSIFICATION: — Unclassified RESTRICTIONS :. 3 CURRENT STATUS: — Redact DATE OF LAST REVIEW: — 08/20/1998 OPENING CRITERIA: INDEFINITE COMMENTS : MED. RPT, INC FD-300, MED RPT | -_-_eooeeeeeeeee rr nr v9.1 13 | Docld: 32984983 Page 1 ‘
Réleased under the Wor’. Kenedy ‘Assassination Records Collettien-Art of 1992 (44 USc 2177 Ho! a ne ie DATE: 21-14-2017 C) | ca Cc nN fe f ty . ed . Yandardrorm 88 . : ~ oe 4 : and fond ore * C "PORT OF MEDICAL EXAMINATION a Oo Be Bt-263-01 *y ye as _, * 1. LAST NAME~—-FIRST NAME—MIDDLE NAME . 2. GRADE AHD COMPONENT OR POSITION 3. IDENTIFICATION NO. (aosts James Pp. Jr. special Agent 92 MAT HOME ADDRESS (Numbor, street or RFD, city or town, zone and State) 11018 Genetta Dr. Dallas 28, Texas’ Male _[_White F: B. 1, | Dallas Field office 12. DATE OF BIRTH 13. PLACE OF BIRTH 14, NAME, RELATIONSHIP, AND ADDRESS OF NEXT OF KIN . Janet P, Hosty (Wife) 28 Aug 2 6 Chicago, Illinois Same as item 15. EXAMINING FACILITY OR EXAMINER, AND ADDRESS : 16. OTHER INFORMATION USAF HOSPITAL CARSWELL, CAFB, TEXAS - WTR RATING OR SPECIALTY: TIME IN THIS CAPACITY (Total) LAST SIX MONTHS 5S. PURPOSE OF EXAMINATION 6. DATE OF EXAMINATION 21 Feb 61 11. ORGANIZATION UNIT Dallas, Annual Texas NOTES. (Describe every abaormaili in detaif, -Enter_ pertinent item aumber before each comment, CLINICAL EVALUATION Continue in item 73 ond use additional sheets it necessary.) & * NOF (Checs cach item ia appropriate columay- ABNOR Mag enter UNE” if not evaluated.) MAL ‘18. HEAB, FACE, NECK, AND- SCALP 193, NOSE . SINUSES. 21. MOUTH-ANB THROAT mf 8 __ (int, & ext, canals) (Auditory 22, EARS—-GENERAL | uity under items 70 oad-71) DRUMS (Perforation) N Lill c — (Visual acuily and telraction 24, EYES—GENERAL ier items 59, 60 and 67) 2s. OPHTHALMOSCOPIC 26. PUPILS (Equality and reaction} 27. OCULAR MOTILITY (Associated parallel more- . ments, nystagmus} 28, LUNGS AND CHEST (Include breasts) 29, HEART (Thrust, size, rhythm, sounds) 30, VASCULAR SYSTEM (Varicosities, efc.) 31. ABDOMEN AND VISCERA (Include hernia) (Hemorrhoids, fistulae) 32. ANUS AND RECTUM (prostate, if indicated) 33. ENDOCRINE SYSTEM 34. G-U SYSTEM 3S. UPPER EXTREMITIES (Strength, range of : motion) 36. FEET idddddddadud . tena feet) 37. LOWER EXTREMITIES rength, range of motion) Pa] Ps] Ps | bd Searched. Newiborad. 39. Pei] pd] bs 43. PELVIC (Females only) (Check how done) - | VAGINAL O RECTAL. {Continue in item 73) TE LEREEL 44. DENTAL (Place appropriate symbols above or below number of upper and lower teeth, respectively.) . REMARKS AND- ADDITIONAL DENTAL 7 DEFECTS AND DISEASES. He, O—Restorchle teeth X—Missing teeth . (6 X 8)—Fixed bridge, brackets to he. / ‘|—Nonrestorable teeth XXX—Replaced by dentures include abutments x 2 3s (4 z >) 3&3 30 29 28 27 26 25 12 «13 14 s fF Type 3, Glass 1 Arm D ammM er 24 23 22 aa 20 19 18 1»: @ LABORATORY FINDINGS 4S. URUNALYSIS: A. SPECIFIC, GRAVITY . 1.026 46. CHEST X-RAY (Place, date; film number onde jaa B. ALBUMIN Neg . D. MICROSCOPIC CAFB, Texas 21 oe 4 we c. SUGAR Neg - #61-3201 __Neg gat ab ' 47. SEROLOGY (Specify test used and result) 48. EKG 49. BLOOD TYPE AND | SO. OTHER TESTS RH FACTOR Cardiolipin Negative Attached Docld: 322784983 Page 2? ‘