Ret eased miter the Ton Ff. Kenedy Assassination Records Collection Act of 1999 (44 USC 2107 Hote). DATE: 11-14-2017 RR AGENCY : RECORD NUMBER : RECORD SERIES : AGENCY FILE NUMBER : ee ORIGINATOR : FROM: TO: TITLE: DATE: PAGES: SUBJECTS : DOCUMENT TYPE : CLASSIFICATION : RESTRICTIONS : CURRENT STATUS : DATE OF LAST REVIEW : OPENING CRITERIA : COMMENTS : i v9.1 i|Docld: 32285718 Page 1 r FBI 124-10193-10494 HQ 67-494012-11 FBI 12/28/1951 3 JFK Assassination System Identification Form Agency Information Document Information JAMES P. HOSTY JR. PAPER, TEXTUAL DOCUMENT Unclassified 3 Redact 08/18/1998 INDEFINITE SF-88 Date: $/27/201
at Released , under the- John F. Kennedy Assassination Records Collection: Act of 1992 (44 USC 27107 Hote). DATE: r ade -14-27017 rd Form. 83. eee oor 1950) PROMULGATED BY BUREAU OF THE. BUDGET... -~- -- + oa 1, _QEPORT re) CIRCULAR A-24a 4 ope ele : te if i . . <1, pee NAME-!~ = ; en AND COMPONENT OR FOSITION - . vi IFICATION 8 me 15. ‘PURPOSE OF £ OF EXAMINATION 6. DATE ‘OF EXAMINATION * f $} . 9.-TOTAL YRS. GOVT,. SERVICE - -}-10. DEPARTMENT, "AGENCY, of § SERVICE . We asannzATiOn WN mi ‘ARY. sCIVILIAN . . (o) IONSHIP, AND-ADDRESS-OF NEXT OF KIN -,--~-—-—~ :13."PLACE OF BIRTH -- MjCA by Jhb 12, DATE OF BIRTH-.-. ae “TEAST SIX. MONTHS) o> NOTES.--Describe every abnormality in detalii. (Enter pertinent tem riaenber, before each comment: continue in item 73 and use additions! sheets if Decoscary, 1 1 { Rieck each item in appropriate col- umn: enter “N. if not evaluated) ‘ile oety . ie i wt] =) 18:-HEAD-FACE, NECK> AND SCALP - ~ 4-- (==) =--00 2 0 ee te eT a. - [ NOSE ; va 28, SINUSES 21, MOUTH AND THROAT i 7 arte Unt. & ext. canais) (Auditery wa 22. EARS—GENERAL acuity under ifeme 70 and Ti) DRUMS (Perforation) .  _«. ~. a - (Visual acuity and refraction. EYES—-GENERAL under items 69, 60, and 61) * 25. OPHTHALMOSCoPIC -“*** ~ -.- hake tek yeta Talo tl ath) 26, PUPILS (Equality and reaction) (Associated parailel more- | 27, OCULAR MOTILITY neers emus) ———} - | 28. LUNGS AND CHEST (Include breasts) =| wa a | 27 wr 29, HEART (Thrust, size, rhythm, seunds) Penge tare Senanen ae | | 30. VASCULAR SYSTEM (Varicosities, ete.) 31. ABDOMEN AND VISCERA Unelude hernia) ‘ : om (Memorrhotda, fistulae) 32, ANUS AND RECTUM (emerrheide.fetulos) | 33, ENDOCRINE SYSTEM WUEIIES 34. G-U SYSTEM (Se th, rai of 35, UPPER EXTREMITIES (Nrengihy range | 36. FEET 37. LOWER EXTREMITIES (Zzeen? fect) (Strength range of motion) 38. SPINE, OTHER MUSCULOSKELETAL 39: IDENTIFYING BODY MARKS, SCARS, TATTOOS 40. SKIN, LYMPRATICS © - 44, NEUROLOGIC (Equilibrium tests “under” item 72)" AQ. ‘PSYCHIATRIC (Specify ani péreonalitiy deviation)” / Fomales only j' 7 o: - : (Check how done) z= | 7 t -A3; PELVIC - El VAGINAL ~—— Chnecrats : re ee TREMARKS “AND ADDITIONAL DENTAL DEFECTS AND | awe a ae 44, “DENTAL (Place appropriate ‘symbols above or below number of upper and Tower teeth, respectively) ~~ O.~Restorable tecth> | X.—Missing teeth (6 X 8).—Fized bridge, brackets to we Oe i-—Noanrestorable teeth . REX Replaced by dentures wee include abutments ° Mae Bacr 8 4 8 Be Tye Bef Bo Wey My BE a woe ee - eee ee ey aye LABORATORY FINDINGS ~~ 46, CHEST X-RAY (Place, date, fim number, resulta am ee ee —_ /S0. OTKER TESTS” ~~! ~ 49, BLOOD TYPE AND RH FACTOR | TY JaN 14 1952 a , Docld: 32265716 Page 2? ‘
“Released under the John F. Kennedy Assassination Records Collection a3) = pug Nee sf Ber's + t DATE : ‘ “aplda 201738 Be an ; z . fe an t baw : es kee ee Dees wreeeene cme oe ee . i P aes . ota be TS Pee , - ” MEASUREMENTS AND OTHER FINDINGS ae ae Pes 51, HEIGHT ” 52. WEIGHT 53. COLOR HAIR 54, COLOR EYES 4 55. ar ved os 56. TEMP. , t : ~ -. | SLENDE! IFAVY’ Cl > 2F Ca (Slack. Vo SpeR mepigay oH) PES 37, 57, BLOOD PRESSURE (Arm at heart level) i bye as 58. PULSE (Arm at heart level) | 1 ~ ot + sos af ae = oes ad re > [SITTING -- AFTER EXERCISE [2 MIN: . "SITTING" Recum. | SYS: ae stanpine | SYS. = 22 ™ 2 MIN: AFTER RECUMBENT: ‘AFTER, STANDING: a fos 2g 64 | see pee PSF 5: VTLVISION | 5 AN 7 Me | 60: . ++ | REFRACTION « . ; SI. fy pw, > NEAR VISION "RIGHT 20/73 4 Perko Tozer BD . Yeo ‘LEFT 20/~ 345 7" "7" SCORR.TO 28) = 7 . 62. HETEROPHORIA: fs. ny ACY ii i j Specify distance) _ES°, | "D Pery. f Ach 1. LH. , PRISM DIV. . RISM @ONV. nn pr (Specify distance) ‘ntl aP Pea ta | Lar ; oo ir es c PD * 63, ACCOMMODATION 65, DEPTH PERCEPTION URCORRECES : A ‘ iL sed RIGHT QC LEFT “Aw (Test use ik on - 66. FIELDOF VISION: ‘|68. REDLENS, Fe [69. INTRAOCULAR TENSION wa _ ° a a: 7 72.-PSYCHOLOGICAL-AND PSYCHOMOTOR (Testa used and score) wh egy (© pg (A | | BS | BE YW ] RIGHT WV": 1S SV (5 at a Yoo. eee ee coe. Cee terrwy AT psy oT py FEE ia 7a | | - - nn sae i f a et fe oe 70.0 0° HEARING: -- 174 73, NOTES (Condinued) AND SIGNIFICANT OR: INTERVAL -HISTORY- a t 7 t ; - : ; (Use additional sheets of plain paper if necessary) . 74, SU MMARY OF DEFECTS AND DIAGNOSES. (List.diagnoses with item numbers) ‘ PHYSICAL PROFILE — 77, EXAMINEE (Check) Is Rs: a QUALIFIED FOR ELS » 1B. AF NOT. QUALIFIED, aa PISQUALIFYING ECTS BY es NUMBER - --— “hae! hr uss a ary 79. TYPED OR PRINTED. NAME. OF ve socprocte aes eee WEDDELL OS SPALDING: 60. TYPED OR PRINTED NAME. OF PHYSICIAN wea ar we as ett tg “ mn * “ . . aoe ““ ‘ I. TYPED, OR PRINTED NAME. ‘OF. DENTIST OR PHYSICIAN (Indicate which)” we . Taye " at ‘ . ont 7 : " on ‘ eee a NUMBER OF AT- SIGNATURE . TACHED SHEETS 82. TYPED OR PRINTED NAME. OF-REVIEWING OFFICER OR APPROVING AUTHORITY aay at \ . U.S, GOVERNKENT PRINTING OFFICE 16——-62288-1 * , LU “ . xy . ~ a . ae +. ; ‘ 2 ; \ ™ —-L.___ + o I . H Docld: 322785715 Page 3 ‘