Agency: FBI
Originator: FBI
From: HQ
Document date: 10/16/1951
Document type: PAPER, TEXTUAL DOCUMENT

## Page 1

Released under the John F. Kennedy Assassination Records Collection Act of 1992 (41 USC 2107 Note) .

DATE: 11-14-2017

JFK Assassination System

5/27/201

Identification Form

Agency Information

AGENCY:

FBI

RECORD NUMBER:

124-10193-10496

RECORD SERIES: HQ

AGENCY FILE NUMBER: 67-494012-13

Document Information

ORIGINATOR:

FROM:

FBI

HQ

TO:

TITLE :

DATE: 10/16/1951

PAGES:

5

SUBJECTS :

JAMES P. HOSTY JR.

DOCUMENT TYPE: PAPER, TEXTUAL DOCUMENT

CLASSIFICATION: Unclassified

RESTRICTIONS: 3

CURRENT STATUS:

Redact

DATE OF LAST REVIEW:

08/18/1998

OPENING CRITERIA: INDEFINITE

COMMENTS: MED. RPT, INC 2 RS, CARDIOLIPIN TEST

v9.1

DocId: 32285720

2

Page 1

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Released under the John F. Kennedy Assassination Records: ColTection Aet of 1992 (11 USC 2107 Hote) -

DATE: 1Fom 4017

'PROMTIGATED BY

BUREAU OF THE BUDGET

CIRCULAR A-24.

Till

REPORT OF MEDICAL EXAMINATI

• 1. LAST NAME-FIRST NAME- MIDDLE NAME

HOSTYO

VAMES

PATRICK

2: GRADE AND COMPONENT OR POSITION

4: HOME ADDRESS (Number, street or RID, city or town, zone and State)

2633%

Liest: MISHAWAKA

APPLICATIDON

•FRI

10. -DEPARTMENT. AGENCY. OR SERVICE

3. IDENTIFICATION. NO.:

6, DATE OF EXAMINATION

00t /6.1951

* Ніше

cohite.

CIVILIAN

3412

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

*280cg1921

Chicago.

15. EXAMINING FACILITY OR EXAMINER, AND ADDRESS

Wendice 2. spalling

16. OTHER INFORMATION

ABNOR-

NORMAL

MAL

CLINICAL EVALVATION

(Check each item in appropriate col-

umn; enter "N. E.'

if not evaluated)

18. HEAD, FACE; NECK: AND. SCALP

19. NOSE

20. SINUSES

21. MOUTH AND THROAT

TIME IN THIS CAPACITY: TOTAL.

LAST-SIX MONTHS.

VOTES.-Describe every abnormality in

1 detail.

(Enter pertinent item number before each

comment; continue in item 73 and use additional sheets if necessary.)

23. DRUMS (Perforation)

(Visual acuity and refraction.

24. EYES- GENERAL under items 59, 60, and 61)

25. OPHTHALMOSCOPIC

26, PUPILS (Equality and reaction)

27. OCULAR MOTILITY

ments, mustaomus)

28. LUNGS AND CHEST (Include breasts)

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

30, VASCULAR SYSTEM (Varicosities, etc.)

31. ABDOMEN AND VISCERA (Include hernia)

(Hemorrhoids,

32 ANUS AND RECTUM (Prostate il indicated)

33. ENDOCRINE SYSTEM

34. G-U SYSTEM

35, UPPER EXTREMITIES

(Strength, range of

atroply of it te

36, FEET

37. LOWER EXTREMITIES

(Except feet)

•(Strenoth. range of motion)

38. SPINE, OTHER MUSCULOSKELETAL

39. IDENTIFYING ODY MARKS, SCARS, TATTOOS

40. SKIN, LYMPHATICS

MẠR

41, NEUROLOGIC (Equilitrum tests under item.??)

42. PSYCHIATRIC (Sperifu anu personality deviation)

Females only

(Check how done)

43. PELViC

VAGINAL

O RECTAL

. (Continue in item 73)

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

DISEASES

0,-Restorable' teeth

(6X8)-- Fixed bridge, brackets to

/Nonrestorable teeth

•-Replaced by dentures

include abutments

- THRON!

se

2

31

3""

30

4.

10-

it

• 12

29

28

22

21

13

20

15; 18

24

23

30n11

LABORATORY FINDINGS

57494012-16

searched

A7. SEROLOGY (Specify test used and result

45- URINALYSIS: -SP. GR.

ALBUMIN

SUGAR

нечи

48. - EKG.

1015.

MICROSCOPIC

Hagaline

49. BLOOD TYPE AND RH

FACTOR

50. OTHER TESTS

sore

FEDERL BUSEND CE IRUZE

It parties

18-82288-14

67-5470-211

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## Page 3

Released under the John I. Kennedy Assassination Records Collection aet (7 392

DATE: 11-14-2017

9104.96

21g7 Hote).

MEASUREMENTS AND OTHER-FINDINGS

51. MENSHT

54. COLOR EYES

55. BUILD:

FD 8: 1. BRONN.

BROWN:

SLENDER

WEDJUM HE

56. TEMP.

MAL OBESE

98€

57, BLOOD PRESSURE (Arm it heart level)

58. PULSE (Arm at heart level)

SITTING

sYs. (30

SITTiNG

RECUM:

BENT

DIAS.

(9 min)

20

64

AFTER EXERCISE;

LE AFTERES

RECUMBENT

AFTER STANDING

100.

66

64

3 MIN.

78

59.

DISTANT. VISION

60.

REFRACTION

61.

NEAR VISION

RIGHT 20/ 20

CORR..TO.20/

BY'

_.S.-

CX

BY-

LEFT 20/

2.0

CORR. TO 20/.

RECHD

V62. HETEROPHORIA:

S.:

CX.

.BY

(Specify distance)

ES°

EXS PERSONNEL UNIT

L. H.

PC

PD

63. ACCOMMODATION

RIGHT

66. FIELD OF VISION

LEFT

PRISM DIV.

PPIAL ANT: UN PRISM CONY.

65. DEPTH PERCEPTION

UNCÖRRECTED

'ess used-and score

CORRECTED

,70.

..._ HEARING.

FIGHT W 1 /issy

LEFT WV.

korset

67. NIGHT VISION (Test ed and score)

U!S, DEPT OF JUSTICE

71.

AUDIOMETER

250

256

512

1000

1094

8048

3000

5fird

68 RO LENG OS PH 3A

169: INTRAOCULAR TENSION

72-PSYCHOLOGICAL AND PSYCHOMOTOR (Teste used and score)

1000

4098

8000

8198

/15

¡Ú 115"

RIGHT

LEFT

73. NOTES (Continued) AND SIGNIFICANT OR INTERVAL HISTORY

Jean amy

strisei nein.

(Use additional sheets of plain paper if necessary)

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

Margily of

it testicle.

75. RECOMMENDATIONS-FURTHER SPECIALIST EXAMINATIONS INDICATED (Specify)

EXAMINEE (Check:)

IS NOT QUALIFIED FOR

trer

78. IF. NOT- QUALIFIED, LIST DISQUALIFYING DEFECTS BY ITEM NUMBER

.....

79. TYPED OR PRINTED NAME OF PHYSICIAN :.

WENDELI

L.

80. TYPED OR PRINTED NAME OF PHYSICIAN -

SPALDING"

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

82, TYPED OR PRINTED NAME OF REVIEWING OFFICER OR APPROVING AUTHORITY

U. 5. GOVERNMENT PR

76.

PHYSICAL PROFILE

al dieseni

SIGNATURE

[SIENATI

PHYSICAL-CATEGORY

NUMBER OF AT-

TACHED SHEETS

DocId: 32285720

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