"Reléabed under thé John DATE odor d bg 2017 a | . Revised April 1968 ; | } General Services Administration ‘A Interageri*» Comra. on Medical Records oa . ‘ER ng: -21.805+ . ; - WELAST.WAME—FIRST-NAME—MIDDLE NAME |] H&STY, James Patrick, Jr.. 4, HOME ADDRESS (Number, street or RFD, city or town, 3014 W. 5lst Terrace Shawnee-Mission Kansas 7. SEX Male 12, DATE OF BIRTH (46) 28 Aug 24 13... PLACE OF BIRTH USAF Hosp, Richard 17; RATING OR SPECIALTY CLINICAL EVALUATION (Check each ttem in appropriate col- umn; enter “NE” if not evaluated.) z ie) ? = ‘Pa} P<] Pd} e nm > OQ m =z m QO x Pd Pd o 2 oO > Fa oO t * # 20. SINUSES 2]. MOUTH AND THROAT Int. & ext. is) (Audit 72. EARSGENERAL_ (TEE ox ar) Radory, 23, DRUMS (Perforation) L (Visual acuity and refraction under items 59, 60 and 67) 25. OPHTHALMOSCOPIC . .}26. PUPILS (Equality and reaction) nN 2 m =< ina ie] nm ~ : 2 a c C > z= = 3 2 cc 1 < 3 ® ° 5. 3 BR a] 3 2 g a 3 3 Ss > Qo m = m az Pad i ments, nystagmus) 28. LUNGS AND CHEST (Include breasts) 29. HEART (Thrust, size, sounds) 30. VASCULAR SYSTEM (Varicosities, etc.) 31, ABDOMEN AND VISCERA (Include hernia) . |32, ANUS AND RECTUM (Hemorrhoids, fistulce) 33. ENDOCRINE SYSTEM" rhythm, ><] bd] bd [>< | pa Iba 1b [<I >a be | ba] pe aa oO m 7 aa} i 4 on 2 a 4 m =, a = — 52 5 ir) i) 35. UPPER EXTREMITIES (Strength, range of 37. LOWER EXTREMITIES RxCePt fee A ot motion) . SPINE, OTHER MUSCULOSKELETAL "99. IDENTIFYING BODY. MARKS, SCARS, TATTOOS 40, SKIN, LYMPHATICS 4), NEUROLOGIC (Equilibrium tests under item 72) w o a \ >¢|p¢| >< 42, PSYCHIATRIC(Specify any personality deviation, 43, PELVIC (Females only} (Check how done) “Ei vacinay. [J Rectat = REPORT OF MEDICAL 66205 Chicago, Ill 15. EXAMINING FACILITY OR EXAMINER, AND-ADDRESS s-Gebaur (KFCS) R-G AFB Mo , . Fv Kennedy Hssassination Records Collection Act of T997 (44 USC 2107 Hote) . PN EXAMINATION 2. GRADE AND COMPONENT OR POSITION SA “13. IDENTIFICATION NO, 354-16-1823 6. DATE OF EXAMINATION Civilian State and. ZIP Code) 5. PURPOSE OF EXAMINATION Annual GRACE 9, TOTAL YEARS GOVERNMENT SERVICE To. AGENCY ‘| Caucasian MILITARY. 3° CIVILIAN 17 FBI 24 May 71 V1}. ORGANIZATION UNIT Kansas City . 14, NAME, RELATIONSHIP, AND ADDRESS OF NEXT OF KIN Janet P. Hosty (Wife) Same as #4 16. OTHER INFORMATION TIME IN THIS CAPACITY (Total) LAST SIX MONTHS | ; ? 2 NOTES: (Describe every abnormality in detail. Enter pertinent. item number before each comment. Continue in item 73 and use additional sheets if necessary.) a * ‘ : 6 a + 21. ‘Tonsils venucleated. 4 r Circumcised, WHNS. lo ms REC-133 Noninfected Scar 1", bo 00 cag.fans? C- Left _sqapyllstedt € 6 JUN 8 197 yy 7 Soom /-REMARKS ANO: ADDITIONAL. DENTA : e in item 73) i. DENTAL (Place appropriate symbols, shown in examples, above or below number of loiper-teeth.), , a it ae <* AMERECTS"AND DISEASES _ x xx EOXD~) pived 7 “ 12.3 Restorable . 12 3 rele ble 12 3 Missing J_2_3 shader § Fixed: Boe 4.8" ' 32 31 30 teeth 32 31 30 teeth 32.31 30 teeth 32 31 32 31 30 dentures Exam type 3 2 x! x Kk 6: : - a *% a et ee a ae | io Ww ow. ww 4s L Dental Class 2 ; H 32. 31. 30 ra) 28 27 26 25 24 23 22 | 2 20 19 18 v F : ‘ T X _ .o) : x . ~ LABORATORY FINDINGS . { 45. URINALYSIS: A, SPECIFIC GRAVITY 1.025 46. CHEST X-RAY (Place, date, film number and result) —_ B.ALeUNIN Neg 0, MICROSCOPIC 14 x 17 Film, No 71-5267 24 May 71 | C.. SUGAR . Neg _ Negative ; R- AFB Mo Norma ; _ 417, SEROLOGY (Specify test used and result)} 48. EKG 49. BLOOD TYPE AND RH ~ |50. OTHER TESTS ‘ | FACTOR ‘l RPR-Neg Normal , ae wo SO 4 ; Hémat: 45 vols%® .° © ‘ iz SS): y JUNG4ISA ne re Docld: 322785166 Page 2?