{ : t A , ‘ ' 3 , é I a ' : j : i 4 7 1 ’ ‘i { . 4 : ‘ a 9 4 : i 4 $ ra . Lt . “sd 1 or om tL : : s ' y . ' 1 i, ‘4 4 1 rod roa 7 ! . boot ‘ ' ' HW 54756 _DocId: 32262166 - HP yt a : \ di 4 i \ : ‘ { oN. - ‘. ; | | ‘ : uy 1 a ' “ ‘ 1 Li ryt! | ode | ty : j ar i on) ' “ ‘ ' . he i \ ! ' = = 3 au . i doneh DO NOT USE CODE BOXES % paret seat tatech Tai | Aa | 43 | // WA | pee CAL] Z| nots Recister No. s made 6. Ace A “fi i 2/1, 10. Source’ or Apxis : °1f AAF, indicate piko ont Caanee Tl. Cause or Apu . or eed : a 3 vat i My ! i! ' M ' Hiy| N | [e) . i ° i Pr f . cy on 13, Digrosrri0n 14, Date or Drsrosrr10! 15. Daxs Lost >: ae my 16. Name ame tees 01 iw “r i. Serpe cae ft) bis form st oe will not Page 2701 Wi | wa wif. = = by aH a
a a HW 54756 DocId:32262166 Page 202 oe pee ee ra [| ; i | . ae 2) Last Nase, Finst Nave, Aisbhyicn Ret 2, Recister No. 3 Ane q NG |. A A ALF fa * 5, Oncanization AND Aitht OB 5 IAVICE ( NAR per ox 4 Lal as Cat Sek | 6. Acz, | % Race |8.LeN¢7b br Sea ie: |. HY eT, aA) “|v fAS 10. Sovece o¥ Anwission C | q i ; poof *Tf AAF, indicate pilot, uonprilgi or Sratus ota a , a , 3 {3 { ! we ‘ ; 12. Langs ov Dutt ne a a eet ° one } {hth > 13. Diseusiriun  - : Pd | | pokes | 14. Date oy Disrosrriani |! | “ll | TS. Dars Lost | Tom” [1 TH 4 i er er 16. Name ann Locations jor Repos TAR roy? ' } . ‘ f F ast Iya. 1 1% Sicnatuse ra ai tf 1 (This form supersedes. D. Mi. which will not be used 1.2 iy boy > a : a { ye : ma : 3 ws ah . 6 tae " Form No. Be epolt} Af this revisigy i glitere) ground pers., ot iy 1], Cause ov Absission, AD eile IGNOSES, GOPERATIO 1 :. O NOT USE CONE DOXBA } 6) ¥/) i Fat Al AZ * { Bz " Bl ci Ce, 1n—40804-3 bs 4 +
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11. DISEASE OR INJURY WITH | 12. DATES AND NATURE OF TREATMENTS LOCATION, COMPLICA- TIONS, SEQUELAE, ETC. AND OPERATIONS REGISTER OF DENTAL PATIENTS Adm R “Exam , ‘ RiP ARB. dare ain bee T 2. REGISTER Na. | a 1. LAST NAM Hel
| ad t a \ i : ; ia ‘ } | aa fs) : 1 1 H i} ‘ i a ' ' ' i : i } i i 1 i, ; i} 1 : ! . ‘ Sy : f : | ; : | | i 7 . “ ; j ‘ { , : an is 4 : ; t L | | “| i : | i i 4 ' HW 54756 DoclId:32262166 Page 206 a. Tgerey spy Pel yy Wye { a i dt | : f; oe ily | idl { . \ | : i rel ( Wt | a Wy Pu ' TA: tty] TH a ' hy 14 wa N H mai : ith Wee iy ‘ip i in lh a ‘ih fe AE | U 4 . lh ! itty a map oY TG pay ‘4 ; {i Vey oy 1 ne ft | Vag biyy : ' ' Tri . . — led ath: Rarogrs Riot, SHMEOL MED “1p DO NOT USE CODE BOXES T. Last Naue, Fingt Nate, [Mio i Fria, a pal | Az | AS PP hath Get a A | f bos : 2 Recisrep No. “' a. ABs Britt al j BADE Bl B2 B3 Ye | or ai pee. , \ p Racdteaitl Ba i md : ; 5. ORGANIZATION AND ARM UB SERYICH if AAF pereonnel, 3 aibelow)® | CL ror] Ht UL te tLe : 6. Ack | 7. wii OF ie 9. Datz ovlApiussion | D1 D2 | Ds , Ruane AK On a me | 21 ltl Sth _ tet To. Source ov Apeasion , i El E2 E3° 1 *If AAF, indicate Hite) oh H-piloe 8 ircay ipers., ground perp... or avn. cadet F 1], Cause ov Agsigsion,: Diacnoses, OPBRATIONS, Cuance oF Status 4 a Car | fi 7276 he Ih | t oe. J Be Qos Qing thy aha 12. Lins or Dut i i f i ° 13. Disposirion | : 14. D. D hess U ATE oF Dipti ‘ . : 15. Days Lost +p es PHosprrau | | Quanrans aE vi. | v2 16. Name ano i NT fu Me Wi W2 1. Sicnaruas | 7 Al a op ot Dod WBA 9, 1 Lo 1 duly 1944 i . : This form supe D. Form Nd: 52, 0-961627 | hich will nel i ‘pt of this rev E os.) 1e-—a0804-8 ft GPpo i
11. DISEASE OR INJURY WITH. | 12. . DATES AND NATURE OF TREATMENTS REGISTER OF DENTAL PATIENTS AdmR _ B D Bag. Repaired ; 8| Cl SB. AAM 22