Agency: FBI
Originator: FBI
From: KC
Document date: 7/2/73
Document type: PAPER, TEXTUAL DOCUMENT

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/ Released under the John F. Kennedy Assassination Records Collection Act of 1992 (14 USC 2107 Hote).

DATE: 11-14-2017

JFK Assassination System

Date:

5/27/201

Identification Form

Agency Information

AGENCY: FBI

RECORD NUMBER: 124-10134-10460

RECORD SERIES: HQ

AGENCY FILE NUMBER:

67-494012-189

Document Information

ORIGINATOR: FBI

FROM: KC

TO:

TITLE :

DATE: 07/02/1973

PAGES:

4

SUBJECTS :

JAMES P. HOSTY JR.

DOCUMENT TYPE: PAPER, TEXTUAL DOCUMENT

CLASSIFICATION: Unclassified

RESTRICTIONS: 3

CURRENT STATUS: Redact

DATE OF LAST REVIEW: 08/26/1998

OPENING CRITERIA: INDEFINITE

COMMENTS: MED RPT, INC FD-300

v9.1

DocId: 32285184 Page 1

24

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

DATE ATY -71-2917

if vised April 1968

General Services Administration,

Interagency Comm. on Medical Records

FPMR 101-11.809-3

LAST, NAME-FIRST NAME- MIDDLE NAME

HOSTY,

James. Patrick Jr

4. HOME ADDRESS (Number, street or RFD, city or town, State and ZIP Code)

3014W.

51st Terrace

Shawnee Mission, Kansas 66205

7. SEX

8. RACE

Male

Caucasian

9. TOTAL YEARS GOVERNMENT SERVICE

MILITARY

3

CIVILIAN

21

12. DATE OF BIRTH

13. PLACE OF. BIRTH

(48)

28 Aug 24

Chicago,

Illinois

15. EXAMINING FACILITY OR EXAMINER. AND ADDRESS

USAF Hosp,

Richards-Gebaur (AFCS) R-G AFB Mo

17. RATING OR SPECIALTY

REPORT OF MEDICAL EXAMINATION

2. GRADE AND COMPONENT OR POSITION

Special Agent FBI

5, PURPOSE OF EXAMINATION

3. IDENTIFICATION NO.

354-16-1823

6. DATE OF EXAMINATION

Annual

2 Jul 73

10. AGENCY

11. ORGANIZATION UNIT

FBI

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

CLINICAL EVALUATION

NOTES.

NOR-

MAL

appropriate

check each oNE propriato ed.s

ABNOR-

umn; enter

MAL

X

18. HEAD, FACE. NECK. AND SCALP

X

19. NOSE

20.

SINUSES

21. MOUTH AND THROAT

21.

Tonsils enucleated.

22.

EARS-GENERAL

(Int. de ext. canals) (Auditory

acuitu under rems 70 and 710

23. DRUMS (Perforation)

24. EYES-GENERAL

¿Viesel cruitu and refraction

under items 59, 60 and 67)

25.

OPHTHALMOSCOPIC

26. PUPILS (Equality and reaction)

X

27. OCULAR MOTILITY (Associated parallel move-

ments, mustaomus)

X

28. LUNGS AND CHEST (Include breasts)

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

30.

VASCULAR SYSTEM (Varicosities, etc.)

X

31.

ABDOMEN AND VISCERA (Include hernia)

XEROX

X

32. ANUS AND RECTUM

(Hemorrhoids, fistulae)

(Prostate, if indicated)

32.

Rectum and prostate normal;

neg.

33. ENDOCRINE SYSTEM

34. G-U SYSTEM

X

34.

MAR

Circumcised, WHNS.

X

35. UPPER EXTREMITIES

(Strenoch, ranoe of

motion)

X

36. FEET

X

37.

(Except feet)

LOWER EXTREMITIES (Strenoth, range of motion)

X

38.

494012-1

SPINE. OTHER MUSCULOSKELETAL

-39. IDENTIFYING BODY MARKS. SCARS, TATTOOS

40. SKIN, LYMPHATICS:

X

41. NEUROLOGIC (Equilibrium tests under ilem 72)

FENCLOSURE

Exarched

Nuubered

REC 030

1 AUG 13 1973

X

42. PSYCHIATRIC (Specifuand personality deviation)

43. PELVIC (Females only) (Check how done)

VAGINAL • RECTAL

(Continue in item 73)

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

REMARKS AND ADDITIONAL DENTAL

DEFECTS AND DISEASES

Non-

3 Replaced

32 31 30

3 Restorable

1

3

. Missing

2

teeth

32

teeth

3'

32 31 30 restorable

31 30

teeth

32 31 30 dentures

32 32 30

Fixed

Partial

Exam type 3

→ dentures

Class 1

R

10

11

12

13

14

15

16 E

31

30

29

28

27

26

25

24

23

22

21

20

19

18

17

XT

LABORATORY FINDINGS

45. URINALYSIS:

A, SPECIFIC GRAVITY

B. ALBUMIN

Neg

C. SUGAR

Neg

47. SEROLOGY. (Specify test used and result)

ARRANe 5 1

719/37

1.018

D. MICROSCOPIC

Negative

48. EKG

Normal

46. CHEST X-RAY (Place, date, film number and result)

14 x 17 Film, No 73-5589

R-G AFB Mo

49. BLOOD TYPE AND RH

50. OTHER TESTS

FAGITORI.

Pos

Hemat:

43 vo1%

2 Jul 73

Normal

DocId: 32285184

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