Agency: FBI
Originator: FBI
From: DL
Document date: 02/26/1958
Document type: PAPER, TEXTUAL DOCUMENT

## Page 1

Released under the John F. Kennedy Assassination Records Collection Act of 1992 (44 USC 2107 Note).

DATE: 11-14-2017

JFK Assassination System

Identification Form

Date:

5/27/201

Agency Information

AGENCY: FBI

RECORD NUMBER: 124-10134-10211

RECORD SERIES: HQ

AGENCY FILE NUMBER :

67-494012-69

Document Information

ORIGINATOR: FBI

FROM:

DL

TO:

TITLE :

DATE: 02/26/1958

PAGES:

3

SUBJECTS :

JAMES P. HOSTY JR.

DOCUMENT TYPE: PAPER, TEXTUAL DOCUMENT

CLASSIFICATION: Unclassified

RESTRICTIONS: 3

CURRENT STATUS :

Redact

DATE OF LAST REVIEW: 08/20/1998

OPENING CRITERIA: INDEFINITE

COMMENTS: MED. RPT, INC ATTACHMENT

v9.1

DocId: 32284935

Page 1

---

## Page 2

Released wider, the John To Kennedy Assassination Records Collection Act of 1992/140 USC 2107 Hote).

548-58

FEOKOLGATED BY

BUREAU OF THE

BUDGET

CIRCULAR A-24 M

PORT OF MEDICIL EXAMINATION

1. LAST NAME FIRST NAME MIDDLE NAME

GRADE AND COMPONENT OR POSITION

3.; IDENTIFICATION NO.

/HOSTY, James Patrick Jr

1. HOME ADDRESS (Number, sireet or RFD, city or town; zone and State)

5. PURPOSE OF EXAMINATION

10344/ ESTAGAI

DO Drive, Dallas texas

ANNUA B

6. DATE OF EXAMINATION•

26 Feb 1958

7 SEX

9. TOTAL YRS. GOVT. SERVICE

10. DEPARTMENT, AGENCY, OR SERVICE

Male

Cau

Dept of Justice

11. ORGANIZATION UNIT

'F.B.I.

• 12. DATE OF BIRTH

13. PLACE OF, BIRTH

14. NAME. RELATIONSHIP, AND ADDRESS OF NEXT. OF KIN

8-28-24

15. EXAMINING FACILITY OR EXAMIMER. AND ADDRESS

USNAS Dallas,Texas

17: RATING OR SPECIALTY

TIME IN THIS CAPACITY: TOTAL

CLINICAL EVALUATION

LAST SIX MONTHS:

detail. (Enter pertinent irem number before each;

NORMAL ABNOR-

"MAL

(Check each item

in appropriate col-

umn; enter."N. E." if not evaluated)

18. HEAD, FACE, 'NECK. AND SCALP

# 39

19. NOSE

M&S

ANT :

20. SINUSES

21. MOUTH AND THROAT

22, EARS- GENERAL (InS. d eTt. canale) (Auditory-

acuity under items 70 and 71).

POST:

X.

X

23. DRUMS (Perforation)

I" forehead,

Is ?" right thigh,

P.S

forehead

BuK left scapular, vs right deltola

PS neck

25. OPHTHALMOSCOPIC

26. PUPILS (Equalily and reaction)

# 34 Right Testicular atrophy, NCD:

27., OCULAR MOTILITY Meate ned pallel mose

28/ LUNGS AND CHEST (Include breasts)

29. HEART (Thrust, size, rhythm, sounds)

30. VASCULAR SYSTEM (Varicosities, etc.)

'31, ABDOMEN AND: VISCERA (Include hernia)

32. ANUS AND RECTUM' (Hemorrhoida, fatuae

STORY 17410010

33. ENDOCRINE SYSTEM

34. GU SYSTEM.

35. UPPER EXTREMITIES

(Strenuth, rande of

motion)

136. FEET

MAR 11 1980

4

37. LOWER EXTREMITIES (Except. Scel)

(Strenoth range of motion)

38. SPINE. OTHER MUSCULOSKELETAL-

39. IDENTIFYING BODY MARKS, SCARS, TATTOOS

• X

40. SKIN, LYMPHATICS

41, NEUROLOGIC (Equilibrium texts under ilem 79)

42' PSYCHIATRIC (Specify and perionality deviation)

Fematos only

(Check how done)

43, PELVIC

• VAGINAL: 'E RECTAL

ENCLOSURE

674

Searc

0.1 2 - 602

RECORDED = 13d

44: DENTAL (Place appropriate sumbols above or below number of upper and lower teeth, respectively)

• O.-Resiorable teeth

Missing tee

1.-Noarestoradle teeth

Xx- Replaced Dy denirer

6X8) - Fired bridge, brackets

include abutments.

(Continue in item:73) NAR 71: 1958

I REMARKS AND ADDITIONAL DENTAL DEFECTS ANS

DISEASES

FEDERAL BUREAU PS INVESMGATION

(7 %)

6.

• ir 7

12.

,13

• зi

• 30

2928: 27:126

125)

24

23

"22.

20..

19

• 15

i8

16

Dianar

ualifie

45. URINALYSIS: SP!'GR.

ALBUMIN '

SUGAR

Neg.

•Neg

48. EKGR

1: 018,

MICROSCOPIC

Normal

49. BLOOD TY. AND RH

FACTOR

HB."

LABORATORY FINDINGS

16, CHEST X.RAY (Place, date, fim number. resul

17. SEROLOGY (Specifi test used and reoll)

USNAS Dallas

Texas: 2-26-58

Film # 625,

Negative

Kahn: -Neg

-vé

50. ÖTHER TESTS

8 MAR 1? 1958

DocId: 32284935

Page 2

---

## Page 3

Released under the John T. Kennedy Assassination Records Collection Act of, 1992(14 USC. 2107 Mote).

DATE: 11-14-2017

13410211

51.

HEIGHT

52. • WEIGHT

53.

COLOR HAIR

LOWI1

4, COLOR EYE

Brown.

56. TEMP.,9

98 • 6

57, BLOOD PRESSURE, (Arm abheart label)

SITTING

SYS: 126

RECUM-

BENT

DIAS.

80

59.-

RIGHT 20/ 2 0

LEFT 207

20

62. HETE OPHORIA:

(Spisuy distance) :

DISTANT VISION:

CÓRR: TO 20/

CORR.-TO.20/

ES°

SYS.

STANDING

(3 mịn.)

Sys126

DIAS. 80

MAN 12

irin at forartilenet)

80

NEFRACTION 2

AFTER

RECUMBENT

AFTER STANDING

3 MIN..

84

60:

BY

BY

61:

NEAR VISION:

CX.

-. CORR. TO

CORR. TO

• BY.

BY

EX

R. H.

iL.H. -

PRISM DIVE

FRISM CONV.

-PC

PD:

63. ACCOMMCDATION

RIGHT

66: FIELD OF VISION

Normal

70.

i HEARING

64. COLOR VISION (Test used and result)

LEFT

65.

DEPTH PERCEPTION

(Test used and score)

UNCORRECTED

CORRECTED

24/24÷

Passed. Habant

67: MIGHT VISION (Test used and acore)

68. RED LENS

71.

250

1000

AUDIOMETER

2000

2048

63: INTRAOCULAR TENSION

Normal

72. PSYCHOLOGIÇAL AND PSYCHOMOTOR (Test used and score)

RIGHT, WV 15' /15 SV

15/15

if e

RIGHT

LET W 15 55V

15/15

"LEFT

73. NOTES (Continued) AND SIGNIFICANT OR INTERVAL HISTORY

3000

8000

810₴

No significant history

(Use additional sheets of plain pager if recessary)

74. SUMMARY OF DEFECTS AND DIAGNOSES (List diagnoses with item numbers)

# 34 Testicular atrophy, NCD.

75. RECOMMENDATIONS - FURTHER SPECIALIST EXAMINATIONS INDICATED (Specify,

None.

T7. EXAMINEE (Check)

X IS:

Annual

IT IS NOT QUALIFIED FOR

78. 1F NOT QUALIFIED. LIST DISQUALIFYING DEFECTS BY ITEM NUMBER

73: TYPED OR PRINTED NAME OF PHYSICIAN:

E.R'IBOWMAN JR LT MC USNR

00. TYPED ÖR PRINTED NAME OF PHYSICIAN

E.G. GRAVES IT NC USNR

81., TYPED OR PRINTED NAME OF DENTIST OR PHYSICIAN (Indicate which)

J.A

' BARNARD LT: DO USNR

82. TYPED OR PRINTES NAME OF REVIEWING OFFICER OR APPROVING AUTHORITY

six - rin

76.

PHYSICAL PROFILE

H. t

E

PHYSICAL CATEGORY!

SIGNATURE

SIGN

ватнан

NUMBER OFPIT

FACHED SHEET

DocId: 32284935

Page 3

---