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‘ 1 H \ lt i | ‘! i sft 4 \ “ | dt ! ; ‘ # te -{ + G. O. Form No . ‘ “ford Awd M. D. Form Nee | By om coatings in use) am Laboratory ......-----.. ‘ Form 551-8 Meorcat DEPARTMENT, U. 8. | Revised June 9, 1842) | 9 June 1942) 7s of 10, which ma: 23 Dees 6 exhausted, arrears ee = oe (Bevised June 9, 18 at j_ su i a - | EP ate one Forty Remarks eccstesesesnenede i if = “— cere ea way “ Oi WD. RLU. Korn NO. bbL6g "Name aft L hen if i; A HORATORY ‘REPORTS ities Grade an Ward * ‘ weneee, EEEM 43 enree es Sse a 7 GPO 16—16969-3 3-12193 ' | 7. al md . i t h 1G—12814-1 3¢ GPS
| nse i |! {hypoth Sree im, | hi | ie : i} itiodl 7 HH Hi AAMT ! t : Hig , rie Hh i, . fil t ; a. Hospitan 98 Gen, SED ; [1. Last Nasg, First NaMg, MIDDLE INITIAL a apo 407 ||.’ nal. toren & “iu | Bal. Toren & 7 b. Warp c. RELIGION ; ia PA EV. ADM. | 2. REGISTER No. 3. ARMY SERIAL No. 4. GRADE Artal 0 012 17 224 450__| Pvt 7 @. NAME AND ADDRESS OF Nea i r ELATIVE| 6, CRP ARRI ee Be Cs Fourie Waviehee Gs: alae (M) |Marioe Hall bety | hen APO a 12 South hast rb &. Aar 12 7. Race | 8 Lenars or SzRvicg 12 (a 9. LAR65 Aviusaion 8 Feb 4 hess se up Last (if known) - by ie, PRESENT vey FP ihtafaa. Lang or Dury 14, BloNATURE OF Wasp’ SURGEON mer de 4 FRA eee at Oy . . wD rege AGO Form xk us. Govennia 1 NG OFFICE 16—40776-1 . Replaces WD AGO Form 8: 33, 1 Jul 44and ‘ if 1945 8 ~33 “ fa . - + MOD Form 664, 31 1 May 29,. which are obsolete. HW 54756 | DocId:32262166 Page 83 ‘4 i . 5007k Cnt \ Ul. Fina DiaGnosis, AD biti th —— OPERATIONS, CHANGE or Status : 3 ls Trfd Deg: Observation for middle ear pathology. , l2e “ bacoy ? oe wenyt cone schs 4 Ran nf JRo- . 1 t ‘ , \ ‘* ; Fi , A .
"SIS SLIP : _ 98 den Hosp £8, ° Bi P tia" os as RAI? 224.4500 Pye to Hg & 6th Armd ¢ ; (¥) Marte Hall pt (gad) fae 306 HA Co ad 111 south East 7th st 1215 Newton Xans, = 49 ¥ 8/12 (a) 8 Fab 49 ob, Trfd fr 250th Ned Sta D Kaw $n, Hosp Apo 305 o bn for middle ear pathology. BATE Cero. 2 &g-l RT IN DUPRICAT: , {AL I PORT must be her d carried atients. br 1200 tavs of the ‘idiplipate copy of ali reports with Trfd Des cbservatd. tala! | IL pyot DAT | 149~-Te. Lfee9 DIAG i. PREPART ALL WRPC I“SiRuctrors: Original of I to'lthe Registras for all Mil Heber day #ollowing admission. Fil clinical record for references non-military patiants. for | A OGRRECTIND MPORT will be su ‘nosis submitted on any vrevio ADDI diagnosis becomes established], reported is cured (insnuh cag be aitated), TYPF. OF REPORT (check one). ‘DIAGNOSIS: state briefly Sut if positively determined, or mani, condition", will be used for) a CORREC THD report will be au condition" changes to « posit Venereal Diseases will be com of the Contact History, ED Fort , fested by" (complete) VilL b aise i 4 nth c ue | 33 & Gen Hosp Form 1 he to Receiving Office ox HW, 54756 4 Doctld: 32262166 Page 64 _ fl TIONAL REPORT will be subdtititted without delay when a additional » +4 fee | Diagnesis Slip is not submitted mitted without delay when any diag- & report is incorregt. AND A . Or when a conditicn nreviously pi the fect. and date of cure will stial Corréeted Additional - oncisely. Diagnosis will be stated tatement " undiagnesied condition ¢ reported. The " urdiagnosed gnosis not yet established and tted when the " undiagnosced 9 diagnesis. Reports for " NFR" eted | ‘and accompanied by Twe copies o- 4, (old USFRT Form 302. T Rs conve Setiiml mene «f. ——— Fi Rab -SIGFED VLR" OFFICER | 4) -
> ee, “1, Woumpseion,* d & orebral ~ ontusion, ~ ervical — final cord — ossible ture C=6 i) Mrs Marie Hal _ Newton, Kan || ¢ : ihe rites 4 FROM: TOs 4 “fi | —— 3. Time of veparturds 98th Gen Hosp AF Ho2 Hi 111 South East) Date of venearturg; - ET eS ee * fT OEE LILES LIES ELE IIS . | A .. A _Skose sreagurers d aoe Pom aa ' 9Bth Gl torm ho 187 ae 12 vep 1649 Disposition Slip "E ii * w Hb, |; § tH iy 7 to dei “a ‘ West ? Vl | | | - ' i ml | e/a ‘| fall Crag Pfe , x) 62st up 8y Piet APO 172 (1200) 2 9/re(a) ‘ 16 Jan Trfa fr 10th Gon ae BO JW Diep APO 172: ldxD KO. ree te cvn esre rge te Duty oy eae oe Mee OR PEE OURAN EL EE ER VOR oe cy tem Xo wraghfer: oe A cL , ee enna som enn a aecimnnticniiametiananmmneianmmnanenemae eA E 10 NLT oe . vyeord Officer - Soy ' te — SEE | al 26 PRC: noGl vitae wat m4 | . mC: Ceutral wad earpinge fay Pts Clo | doom KA Tilt: a #) Hid Libraryy,, .N . uegistré \,