ig | NE a ~ : wy . ‘N i* ra oo en .. B- Zi . co — ONSET “t: ae a _ ee S| XQ | gs oe FEB 8 Grade weweee ft MMe. nnnencnne - oe - \ ot g _- - ; ™ a a — oi ib ¢ So ~ ; if & . oe ne H a) ; : ° ~ — aoe STL Ss = z =F -- 4 Fa — “g - — - oe _— — reat eewtee pe Chet — - \ Sa Te E i | ror. 2p LAL et nr ae ot &. ae ination for foed ination of dental foci. * ; only is desired, check here; WD AGO Form 8-43 8 AUG 1944 (Supersedes WD MD Form 55E-%. 31 May 5. Probable period of hospitaliza Vi - pe a“ i Page 85 6. Infectious lues? Of $. If special exam: 2.. 1938, which may be usod until exhausted.) | i. 16—17835-2 old: 322627166 os -———-- — ————— ——— een ansehen ae a a _ - i ee Le ee Ln oe preteen eee a i \ | . s a ° ° | WW 54756 |
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an, SOsps An ‘ a eee ee . _ te = Pag a - ~ - - soo BE S Nea? - ye wee ont . ies on mn . a eo - a - 3 oT > i} 2 CI £- - _— - wees - a a eo a a) Sse ee - 5 - . 1) fe aoe eee aS ~ & b=) 9 . Q : i ~ . - a ‘ oy en ee ee eee eee c. ~ i 7 i ~ _ - _ L ee & a ees ia . U.S. ARMY Form 65L EDICAL DEPARTMENT, ' (Revised May 31, 1939) ns a re a rr ete eee — Sars = 22 — = = soiree ed eee eS ane a ne ne we a aS SS SLUT BO Ue Scien Se cca ened detente Seem sie eee rn ee weer eran woe ee woe ee = = ~- SO eS Se Oe ee wap rs Se TET eo ee ee eg en ae, ee _o. ra = ee a oe Wee eee oe were a - ae aoe ee. -_—--— wee ee eee. - -- - » 4 o oe,  . ~ tae —- 86 oe = eo: . ae
t iy ' ‘ 1 l TV DIRE RP RTS a yMnOL MCS 67. DO NOT USE CODE HOXES 1. Lasr Naue, Piast Naw i & InrriaG ; Al | Az A3 . 2, Recisten No. 3. 4) au No. 4. GRapE ‘| BI [BZ | BS an: : i 17! Bea 450 | Ret 5. Oxcanization ann Any dh Sehyice (if AAF personnel, eee below)* | Gl, (or) \ , 6. Ack | 7. Race [s. 5 GF Senvice| 9; Date oy ADMission D 18 W 20. Source oF ApAissi0 i ’ *1f AAK, indicate pilot, ny abil lying pers., ground pers., or avn. cadet 11, Cause or Avaission, # iGnat Diacnoses, Opegations, Ciance oF Status 4d ; ‘ Spilepsy obs. for y ; 12, Line oy Dury 13. Disrositi0on 14. Date or Disposition 1S. Days Losr»> | Totat UZ. Sucnatuns W2 W.D..A.G. 0, FORM NO, 8-24 j lJduly 1944 (This form supersedey D Foren No. 82, which will not be usott |aft ptiog this revision YB 16--40864-2 WaPo |
eh fe - | | te 13 “01 . Reronts Moxtrot dyspou MCS 67 £ —. po NoT USE CODE BOXES 1. Last Name, Fins? Nawk ky fivpee ENTIAL Al A2 A3 2. Recister No. i z Bl B2 B3 "17 660 (224 450! Pvt 5, ORGANIZATION AND AK! #08 Srevith (if AAF personnel ate below)* | Cl : _inf, H.; 6 Ace | 7. lace i 32] 9. wary ke 19 W iy, 10. Source oF Apstibs| . tl Disp, 6 ‘STF AAP, indicate pilot or Status 1. OCserva , pathola 12. Line or Duty , 1. Yes Mur 14. Date or Disrostripn 15. Days Losr=> | Tosa) 16. Namu ano Location py 250th Med St UT, Si GPATURY Ae ~ eI 4, (This form supersedes which will not bo: Et E2 E3 won-pilot Aying pers., ground pers., or avn, cadet ¥ 11. Cause or ADMIggiON \pprTioNat Diacnoses, OreaaTions, CHANcE G H 13. Disposition Tri to 98th Gen Hosp . T ith \Germa bj 8 Feb u Hosprra. Quanrexs 1 Reronvina InsTaLLarion i ty Ld HOS DO ecrensouy Germe a) : CVO USA REGISTRAR Y. D. M.D. Form No. & . Alter recoipt of this rovision. 16—40804-2 Fy aro
| i | ‘ yy tft : \ | F a ' : cl qea | ' a vf} { ae ew RE oh : file uy qe W ' 1 ‘| i ns . t - o . ' t i "ARPOR is CONTROL SYMBOL Mcs 67 DO NOT USE CODE BOXES 1. Last Name! Firs! [ene idle ‘Initial ' Lo , yar A2 A3 . Hall, Lhoren 2 se ‘ i : 2. Ragiste Bogieter Na re ar ~w [a Grade- ~ o |B B2 B3 l : . ye -_ 62° WHD722nn50 | Ret _ 5. Organization nl ervice (il AAF pe personnal, see below)" ' 7Ci¢ J | C2. Inf Hg Col shh’ Armd Cav’ (S' Gon) . " 6. Age | 7. Hage | “pnagth of Service | 9. Data of Admission Di D2 D3 ¢ sip) " . - 18 | oar 1! 8/12 22 Jan ho... 10. Source of Admibpicn oo , ’ sot Et ye cs . Direg ° pot “TAA, inditiats gi __|F. G @ H ; . t . 2: J +. . T . ‘— es an | el e _ 5 . Qt | 02 ® RB i 4 . ; - a uy - a fee wa wee af eet ng Installation 7 hey ts Gon) Straubi. nt Wwe 47. out ‘aR™ ideal han c3 _ \ Soe Capt NG. - ' G fj lWwoaeo~ 1 HW 54756: Docld:32262166 Page 94 ea oes
2. REGISTER NO.’ 16. AGE} 7. RACE ig 4 ‘if | ; : ‘ I bo i I a 1 H yoy ' ‘ | ne |" | I . pi yh ‘ ; ni} ae i q | iu ' 1 1 1 t ‘ ‘ Hi : 1 Lat ! ily t ' ] ‘ ; yc | [ 1: LAST NAME. FIRST NAME, 3 ‘9. DATE OF ADM, 9 Feh 49 henistancll procedure Is used. Nt 41 I t6—20622-2 il QO B es ) B 3 ~ 9) i wo N ie] far HH 4 35 oz > fe ax Qin do Q™ az g pay z E 77) REGISTER OF DENTAL PATIENTS i Y; "213 “AVTINOSS ‘SNOIL *YOITIdWOSD ‘NOILYDOT HLIM AUNFNI YO SSv3SIG ‘i ry is “el aupy If kg SMuVWaY ONY SLINSIY a
HW 54756: o DoclId: 322767166 ie ga yaa 16 18 4 B;#2 11 10 9 id i OCCLUSION |; ' | | PERIODONTOGLASIA Ale loug | DENTAL FOCI'SlJs ma | OTHER CONDITIGNG) re ' i | weit é r y ‘ : LA RIGUS TEETH BY O NONRESTORABLE Gi MISSING NATURAL TEETH BY X TEETH REPLACED /BY! (Horizontal ti | TEETH REPLAGED iB ED BRIDGE ‘ (Oval to incluge eye) ay WD AGO Form 8: 15 MAR 1845 Page 96 . RT OF DENTAL SURVEY er UPPER TEETH? - } ot i | mc a Bari CLASS, [/- (Tr - ("] ves This fc form supereates WD AGO Form 8-116, 31 May 2044 (formerly WD MJ) Form 79) which will not bo sod upon receipt of this revision, oS 36—20023-2 3 aro LEFT f 12345 67 8 Haan LEFT 9 10111213 14 15 16 CALCULUS: SLIGHT, MEDIUM, HEAVY [c]-no HARPER, COL.D.C. a a _LCXD}
ry S HW 54756} Docld: 32262166 rn ee | idea 1 port Pada piooa eohy IF | boa . 4 ' ‘ | | 1 ar i ' ' 4 y "1 | { i yO nee i | “it! I 4 HE! , yagi Ue | tay oe | ee eee i, Ay He t Pp oe ee Sees ies | \ Aon fi | mi ' { Ria DO NOT USE CODE coxES Ve Last Nase, Pu NAWE( Mobis Intrian * AL | A2~ |-A3 2. Recistrn No. hy Sanat No. 4. Grave Bs 2 B3 2 qi4 | ' Baber 450 . , - ORCANIZATIO al BAG Senyyce (if below)* | Ca c2 ONDIE CERT: a peas ar : mad fu YW 6 AGe [7. Race! aes 9, Dats ov Kommesron Di D2 D3 Veiisyl 7: i) b )} g eb 49 0. ay ™ . 10. Sourcn oF Ay re PA fr 250th lied | El E2 E3 he leg : la ne rr "if AF. indicate hide breshstor fying pers., ground pers., or avn. cadet’ F I. Cause oF Abstisbiby ITIONAL DIAGNOSES, OPERATIONS, CHANCE or Status | ey i Hl (a) verity bbl it c (hy 2 Prev, tt WRetive Sv if - . i Dew 3S, perceptive, cause undetermined,| ieft, Hearing 17.0 de~ ———— cibels logs jaVetage conversational 1 range, rightt 1 38. QO left. ~—— iit K | | c tha | oii ft Wah pa |e ma N im Specialized Treatment - General Sur- \ 8 gery. | ail | ' vl il a | G2 i Bit wn ; R 12, Line oF Duty i Yes aie : 1 us th Ts. Disrosion the . T Duty - Gener , pervice ‘16 February 1949 14. Dare or Disrozrrio: A ‘|, 15, Daxs Lost > “Potab |, Dosprrat 8 Quaatcns i 8 Vi] v2 16. Name anv Toaent " PCURTING INSTALLATION 98th General oppital ,liunich Germany wi) wi 17, Srenaron: A ae B.L.isemig ees OUG, USA »Ass't, Registrar W.D.AG, 0, 1 July 1944 D. M. Form No. 5% or ei aod. (This form supots 7 which will not iid 16~—ansne-1  3¥ GRO Page OTF.
HW 54756 | DocId: 32262166 1, Last Name, Fa _Hall, Lord & Ruseten No 7. Kace W 6. Acz 19 or Status 17 Oct 49 12, Line or Dusy 13. Disposrrion 16. Name ano Log 17, SicnaTuRs which will not! Page 93 “If AAL, indicate pilgt, 1k. Cause or Anosnys' tt ‘4 14. Date or Disposrtion 15. Days Losr > [Tak 7 [U HosritTaL QuaaTERs " ia | | "|" Bio ae TING INSTALLATION = bIsP HO 3 Ei | ¢Vhis form sah t) ———— +5. Oncanization annAlh pay “Fae 7712 gr ut 10. Source or Apauisioyl ly Ws i \ ui ui TD Lh fps anil Hi ‘| . i CSE cvcees | ELAS o 4. Gnavg | 204 A450 Prt i . af RV ICR ic ;AAP personnel, seq below)* “CI INTER, SCPOOL(cadre) y. Dare o¥ Anmission DL bz b3 rajor iu VICK 17 Cot 49 “OS bt ‘ny Ag ‘pera. ground pers, or avn. catlet ti DDFIONAL Diacnoses, OrEenations, Caance if | 72 drsyrpp ees gl Det epitlacty’s 3 & boys tal Gaels “2 | | ate Thay Len Us the eof. EUCOM INT-SCHCOL |W roar won “of Foe whe i 16—t0R14-2 % GPO
‘ Pp iE . ee ry Hf i Tye, } i . | fy . ; . j 7 ae on a a soo. ; H nie bi | I, Aly ; at will vB ta i ye 1 ae | } ji | Ae 1 ( is Wade ( | | un il! ! | ’ ' . ! , { | : ' | | ; : i A . | |i WD AGO Form No. 6-54) [ i. waconD r oe Fy x rea a ¢ £ Ie |= hes Lae . . - fey cr a cee HH . = ‘ ed Ae 7 U te al — - i { » it li ul il tl tt li il it lt Ut i ui i tt It u I cs &. i Laan z | l t ao | { { { { ry p Q, @ (|! Name fea Z Mier 'S io _teraae Ward ah ET | a Z | iii (lhis sheet to be wae ih conjunction With 55A,i1.D.in cases / fyi where the data nereplt 21; suffice to conform, with existing ji regulations. ) | i M, I : . 4 i Pertinent histo phies complaint, and condition on ad- i. mission. a ide tr .Complete physighil:& xamination is nes. valve except for the following: ST : _— ae K reg We * 54754 |}DocId:32262166 Page 99
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= - 2 oT ee err er aa wae ee we be ee Lee - ae t ~-~ — _ 2 » 2 & < a p bee 88 Z £5 < Oe ge a a < .8 a a a” (Revised May 31, 1939) ocld: 32262166
4 we o. HOsritaL 98th Gen losp' AM b. Warp c, > i &-1 ad) Mrs 111 South Bast: Newton, Kan f£ Dis. Di. BIC “Inj” 1, Last Naxweg, Finst Name, Mippis Init1an Hall, Loren E | Pizv. Abs. }2. Reaister No. gee 61 447 _| 8 ARMY SERIAL No. , 2A17224 450 er¢bral onfusion, © ervical © pineal cord v/ngssible —— Ing. i Ap ae tNG o Ores ER 10. SOURCE OF ADMISSION Trfd fr 10th Ge Tsisp APO 172 iM. Pinat Diacnosis, rer at DiaGNosgs, OPERATIONS, CHANGE oF Status (a) Verified iS pon cancly at. mmochirade out aed) Shekel ahevcal RxOR O10 A NA 1 Ba a ; { ty ‘ . oo : ¥ \ Aa. i‘ 50, 2040 ban, Howmet Sas ! : whan pi. | ere bree On ws oan | f Ruy M2 | | af , y | eg vfs . we . | HW 54756 |. Last (if known) PRESENT 12, Ling or Dory DocId: 32262166 Page 102 — | SERIAL oN ca Tee 744 , tae . ° : ve i a . : 7 ’ . . , i ' ' . ‘ ' rc _ Replaces WD AGO Form 8-33, 1 Juld4isad WD ‘ MD Form 538A, 31 May 39, which are bbsolote. . . a
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*REQUIRED 71 % 224 250 Pfs DIAGNOSIS i A deavices _ ONLY WHEN SLIP ny ‘ Pua NP Se FP at A 178 STENCIL 9, DATE OF ADMISSION® PROCEDURE S . 1S USED 2 a tow Gen “fep APO 192. Ht INITIAL REPORT must be forwarded to Registrar by | 1200 of the day following, “dniission, File duplicate copy with clinical record. Answer sf allilems. The informati m ed only be tentative, but should be as correct as possible. } A CORRECTED REPORT wi ll be submitted without delay when any information-sub- | | mitted on the initial reportiisfound to be incorrecti*as in a change of diagnosis. AN ADDITIONAL REPORT aa @ submitted when supplemental information (including additional diagnoses) becom 8s available or when a condition is cured. . RRD|OFFICER . 13. WARD NO. | f 14. TYPE OF REPORT (Check onc) a | | 15. TYPE OF PATIENT (Check one) Clit =O) correcrep ADDI ‘1 Csta.uose, (Jrec.nosp. [1cen. nosp. fil NEUROSURGERY [| TROPICAL DISEASES | CLOSED WARD NP || OPHTHALMOLOGIC SURGERY Pia | VASCULAR!SURGERY | TRENCH FOOT F HI TUBERCULOSIS = FEMALE Lil ARTHRITIS [Fueurosveimis 5 , | teers RHEUMATIC FEVER as i | spplenercee | : iH APPROXIMATELY _____ DAYS O FULL DUTY Ol Line (0 RetireMeNT i(Jcpp to own care =] trateteRiro var © ([] TRANSFER TO OTHER HOSPITAL {ta HOSPITAL RECORDS REQUESTED probable CDD, record all previous hospitalization in U. S. Do not} inelude records on ward.) ; , DATE OF HOSPITALIZATION
| INSTRUCTIONS: 1200 of the day follow F all items. . The inforzi Bi. DATE T 14. TYPE OF REPORT (Cheek pi Cinta corrected 16. SPECIALTY (Cheek one) GENERAL MEDICINE GEN @ ORTH SURGERY OPEN WARD NP ; || THORACIC SURGERY BLIND AMPUTEE (J Fruit puty (CO cpp to own care WD AGO Form 8-1 76. HATION AND AKIN OFgSERVICE® N Isetst MP Sy Plies APO 172 ie 3. LENGTH OF SER.® | 9, DATE OF ADMISSION® | 12 9/12 16 Jan 60 f mu tj fa noed or Kt 7 ohe) IN APPROXIMATELY 120L 945 “REQUIRED ONLY WHEN STENCIL PROCEDURE" i$ USED . ial of INITIAL REPORT must be forwarded to Ragen by File duplicate copy with clinical record. Answer | ed only be tentative, but should be as correct as possible. | Re Y will be submitted without delay when any information sub- bet is found to be incorrect, as in a change of diagnosis. AN Ange be submitted -when supplemental information (including btetdrhes available or when a condition is cured. 1S. TYPE OF PATIENT (Check one) COsta.nosp. [)rec.nosp, (cen. nose. |_| rropicat DISEASES [eLoseo warp np. OPHTHALMOLOGIC SURGERY CLOSED WARD NP . VASCULAR SURGERY | TRENCH FOOT noes | FEMALE | farraamis PW OFFICER A peupence Lueuagsurcerny URGERY DAYS C) retirement
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ecennensenecaTivetnnnescnnasntnasssauananersenussenerretavercrassrsnateretensaneentesttasenanecennstanmanacuuenereseecnaseensateneerenaesteaserasetianarenasethretensetturrntnsseuueseneertnsnassunaesssettttnupeenectugerqnasessonenteumaenuannerteseettnnrvans teegeneae nepenseennnerrerveneeresetnsewemete eect ' : ' : ~ ; : a _ a ~ ) *. : = : 2 . : . ’ . . 7 4 a 4 a * . 7 ~ : on * . ~ - i <= 4 . ~ x) . : ape - eee - 3 oe ~ ac. ~ - . - « : - = 3° = - : ~ e. . - @ wa 9 i“ « . ‘ Page 109 ‘Form 55 C-1 * Blood prossure s Systolic... essai MEDICAL DEPARTMENT, U.S. ARMY _ ; (Revised May 31, 1939) . s ‘ . + “ . _ al " Nome. MWD | Height: Heart: - _ Skin: :|Docld: 32262166 HW 54756
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{CONDITION ON ADMISSION—PREVIOUS Ward y .) ERSONAL HISTORY Grade’ Gat... 4 rte ) hack [dow in 2. i} ati at mission: | | | General appearance and condition ‘Chief complaint: F : ae eee ae mae a8. : a Qu (94 Be Quarts Jw fom Injuries: Venereal disease: seam cee Npne o nn cw ener n ne mens en ennees scene nse nee ears ene mewenenenewsnnaanan ene sas snmeaenes
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v " | RADIOGRAPHIC REPORT (Use reverse side for additional, sa att i | SUMMARY oF PERTINENT CLINICAL HISTORY, PHYS! ‘ ' hk No evidence ol} ti cee: ee Cpt Sita dase MASE po ose 7 Oy | ““IMIOSPITAL OR OTHER MEDICAL FACILITY) ~ if il "Je=-16—68906 af 5 Z | ; ~ ‘| t Form . My 8 amma BESEENE, 4 (Revisxd May 31, 1509) | re ° ; ‘| | co ~ | i, sini i ee Ly ~ (Ul Ecqjnensige W Vos 1 CHR ETCHER pequeste? ( P ) 4 4 yep PATIENT K oon 38 aA RY ; Hy AMBULATORS : | 1 GRAMINATION REQUESTE 1 - 1h At ae { : ee PHYSICAL i: _s CLINICAL pISTORY. _ (eeawAne OF PERTINENT Rev ao S| of Coueuss'™* « 2 ) | Carne reverse aide FF cdaonal val | PORT UE HI RDIOGRAPHIC RE . ‘ AMIE ra . , a OM f : he  apnort Ls : Wo 3 SEH UE | " if ' 15 hn i i et ‘Ay ‘| {. i - / i | yo — 98th General Houpa | 1 (Cheek one) PATIENT'S LAST NAME—FIRS} NAN MIDDLE ME _. | REGISTER NO. WARD NO, N) cosegee ween | ou. , Loren tla | ee oo BED PATIENT ae bY 3, La DATE OF REQUEST , - Gl amputatory ely Me Be 16 Janusry 1950 EXAMINATION REQUESTED I “AGE SEX nortable: AF and later 20 rele CERVICAL S PINs -or dislocation. re a 4 : 1 YOR ( Lo gan DO (DATE OF REPORT) "4 REPORT MADE DY——Inidlale) Standard Form 6180 Promulgnted August 1948 “By Burea of the Budget—Ciroular A—32 RADIOGRAPHIC REPORTS _* wee ep eee ee 4 oe ye Oo - wearcccccenecce: |
"RSING TES AND CATMENT cORD “RD NO. Plnarsd Ix Lan_| | 7 a «dg cs tame oo = a . - z aa = E= | Sa = FS eS = eS ae t = = SG = = = = Soe Se — = . mes i 2 == “<r - moe + a = Ee = SS —— —— SSS SS SSS > ———4 =S==" — —— a SS Se Se eee = == Fe = a a ao SSS ———— paouission] GRADE | HUST Dee PX avd WEY Aloren . FE i | 4 5 -. - 4 = panna jaeeeend - iss Bescas — SI f 1ES we elt dpe % Bate ade ie ' : ' $ i if = ’ i 0. Mme cen ee nee teen nen Ne ee i \ & As \ Ny) Pe fit tg est =| a i soa | jo700 hats eco || Pt foro eee pte Tf LN pesca] PN es a eee rist irl | yi ty to pA | | PN TT sco} ENT AT ALL \ [or a ee ee a x ee ee ee a es ee Par er TNE Nf Norn ‘ ‘> PTT CAPE PEL ELL i DIAGNOSIS 7 i °
tei. 2 et E —— a el ae so mT rere tif oa 7 Ty ERATURE |GRAPHIC CHART | : by rede H . pos Bil- koe Fea TM Tere Peo |G : { aE a A (ee cg a a | ©! [PHOUR OF DAY TT To [ral Teofee Ps To foal TREAT Tt] a 0 [atjee [+ To [oe}ee [enon J | fas [+ To Jos[se zo}ee fo fo afte] e0 : 1. Resp, |PutsE| TEMP i r ek Hee EEEEEREEEEEG 50]: 96° o MOUTH ‘| PARENTERAL a < t, Y : W og A) S Ty is ae ld [stoots BLOOD PRESSURE MEDICATIONS = . W.D., A. G..O. Form No. 8-57 ‘ 18 September 1944 : ' js form supersedes W.D.,.M.D. Form 55 H-2, 31 May 193), 1, mahtil existing stocks are exhausted. om) ’ ua DocId:322627166 Page 116 cites d EERE EEE EAM {| PEEEEEEEHTIS Ficion-ueiour baee, RRO MRT PET | asda | y q : g Ole - Pte - fo ji a GEN, "QO @ TEMPEPATEN™ fo’ fe) (our x — Sei OCG HEH ARABS pace EEL FT ‘ é 5 ol i ahs a vy . t ae ot . il . a Tj = . penn]
bee = + ; F gt tT i a Gl V7. ZL A ] (WD MD Form $A), in casos where the data hereon will suffice to conform renee a we ee ene nnn nnns nen ndn enn ennacenseeee Ht HOTH SIDES OF THIS' BHEET) 16—32789-2 1944, (Old WD MD Form . © xisting stocks até exhausted. ~  -- ‘exist A . NJ: a. 4 3 : j=} : hp” ‘ , ce rt Tr re 3 3 x i os i, g . Z woe Aa) ° ! 7 a= aa aot EAS = _ § — : fy ae a ” ay 3 , at : 4 “ . " L ‘ . 2 oe a 1 y x, . al . " . 7 u i " ‘ e a (oa u at HT y fH a with existing regulations, - Complete physical examinatj
poe. TEMPERATURE— 4 | | 1 | ‘ , tl ! | t ’ ; rn Pot _ a ote ; ‘ . d i i . , 1 7 1 4 i , a swede, ‘iteorcamon AND Nupar’s Norzs | Station eT MERTTIN a Examination equested by ..... neo four We: f iat A : “ i ap — DurzrantiaL: Neutrophiles — Monocytes —. R. B.C. morphology iat tli ‘sanljerepeensarensscenenscenreerenn= Parasites ar bill neeweneeneee foeeranenecennceeenenmerenent Clotting time ——._- a Sedimentation rate WD AGO Form o1 WD ; : SEP 184 1 8-67 f 55 1 _ bs December {90 which ma; 7 be eo used ove . , stocks ere . = Geo 16 7Ae-s ‘ tr ¢ = 42193 _ HO A HH 8-69 WD MD Form 55 5b TBs, ee eel
wee et 1 DEC. +948 u-déu cu oc LN : x [ibleeam ne ctalteagat DATE ____| Da por DHISSION a Mina y ‘ t he : edhe : at . coal 3 thy a iy Mlb ed ] if i a ‘ i rele cD ‘ a qe ' ‘ at l ‘i 4 : 1 Ni il i i ! fhe tly ‘ ‘yt ‘ Al! Hy . }: il 1 \: : \ not thy ir te yt BAI! aly He dn. BR wheel. if At to304 hes. 798" Keay th hen ol ‘] more Codgue_CAP. T-@ bps Ice Cap to. kt dues. HF LU, Leg elevated. j 12-8 =F @ O80. Hifi lcar 7 0 gow 98 fate: s ee P02, ek bef P= GCA B.A700 A Mi ene i co a fe tee eh | | - mia TS “S| - yo I . { i \ { . H it ‘ Mp ‘ . : ; se 7 + SS ~ : i — — = = = = _— ‘ = erento a t ~~ = = ' : oe t ., [eo “| cs i : = = ~ - j 5 = — os a = ee - A —_ 2 ee : = = = ans , A ’ ies r r ' . ' ; t ‘ 4 } iy i ‘ i i 0 : . 4 \ 2 i} (4 ipROPEa, COLUMN Cy THE END OF EACH PERIOD ON DUTY NURGE WILL pcaoid AK J Pe. BOTTOM LINE HPPOSI'E EACH ORDER COMPLETED AND WILL EN TEA HER CERTIFICATION THAT DUTIES INDIOATED HAVE BEEN COMP; my tty of > ARMY. SERIAL NUMBER I pats | GRADE 2) Pre ; ua ai ' ai 4 t ae 56s + ' i ‘ ‘ i _ ot 74 H ee eee ee Geel eT on NURSING NOTES slols 5/5,S/S/S/5 & al mln alm) Se) ale a al ein, ale am w R-3E eS em HA DIAGNOSIS [covey sow he crt Sihie eer eee a ee alias
HW 54756 = ‘Dbocld: 32262166 eH | Hit th i y : ‘ HeOT Ts — on SysnoL MOS 67 DO NOT USE CODE BOXES 6 min dace Inirian eo h APE OTN Ne g : | 4. Guapg + A ny OB BtAL No. ie U7224450 Pfc nvice (if AAF personnel, sec below)® | Cl c2 at We P| Sw Platoon Bat rit oy Seavics 9. Dave ov Apaission | D1 .| D2 D3 (oly 12 [28 Aung 50 | bay 7 El Ea E3 tT fe Direct Ipiioe, noH-pilot Oying pers., ground pers., or avn. cadet F hion,|Auprrionat Dtacnoses, Operations, CHANGE 11. Cause oF or Status CF ae at \ —— * o= \~] ‘ oa no bod SCO CAPT mC. 1 duly 1034 De oeaipe of this roy striae) Ost 16408642 * apo a ie J os : ct oc [ | | iment internal, of ieft: [7 Lone ligament medicums. — 7 i in foot-ball practice I ere 28 Ave 0) | in Garmisch 1 i K | : L . M N | ‘lo H P | R ‘a - 1D Yes | ayy eneral vervice T Hodisn | 29 Aug 50 | v" H3 TAL’ Hosprtau \ Quaatens ah - 1 ww b> RAEAHION oF REroaTiNc Taseaccapoa ———— ay Dispensary APO 172 wi | W2 ao,