Agency: FBI
Originator: FBI
Document date: 02/28/1963
Document type: PAPER, TEXTUAL DOCUMENT

## Page 1

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

DATE: 11-14-2017

JFK Assassination System

Date:

5/27/201

Identification Form

Agency Information

AGENCY: FBI

RECORD NUMBER :

124-10134-10298

RECORD SERIES: HQ

AGENCY FILE NUMBER : 67-494012-111

Document Information

ORIGINATOR:

FROM:

TO :

TITLE:

FBI

DATE :

PAGES:

SUBJECTS :

02/28/1963

6

DOCUMENT TYPE:

CLASSIFICATION:

RESTRICTIONS :

CURRENT STATUS :

DATE OF LAST REVIEW :

JAMES P. HOSTY JR.

PAPER, TEXTUAL DOCUMENT

Unclassified

Redact

08/21/1998

OPENING CRITERIA: INDEFINITE

COMMENTS :

MED RPT, INC FD-300, MED RPT

v9.1

DocId: 32285022 Page 1

16

---

## Page 2

Released under the John F. Kennedy Assassination Records Collection Aot of 1992 741 USC 2107 Hote).

DATES 11-14-2017

¿tandaro Form 88

(Bos2/009.0956)

86-103-01

': Lo:LAST NAME-FIRST NAME-MIDDLE NAME

HOSTY;

JAMES

PATRICK

JR

a. HOME ADDRESS (Number, street or RFD, city or town, zone. and State)

11018 Genetta Dr, Dallas 28, Texas

PORT OF MEDICAL EXAMINATION

2. GRADE AND COMPONENT OR POSITION

3. IDENTIFICATION NO.

SPECIAL AGENT

7392

5. PURPOSE OF EXAMINATION

6. DATE OF EXAMINATION

Annual

28. Feb 63

7. SEX

Male

12. DATE OF BIRTH

8, RACE

White

13. PLACE OF BIRTH

9. TOTAL YEARS GOVERNMENT SERVICE

MILITARY 3

TRIVILIAN 11

10. AGENCY.

11. ORGANIZATION UNIT

FBI

Lallas Fleld, Tex

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

Janet P Hosty

(wife)

(Same as Item 4°

28 Aug 24 (39) Chicago, Ill.

15, EXAMINING FACILITY OR EXAMINER. AND ADDRESS

USAF HOSPITAI, CARSWELL, CAFB, TEXAS

17. RATING OR SPECIALTY

-

16.-OTHER INFORMATION

TIME IN THIS CAPACITY (Total)

LAST SIX MONTHS

"NOR-

_MAL

CLINICAL EVALWATION

(Chack each item

appropriate

column;

"NE'

not

evoluated.)

NOTES.

(Describe

Destrive inveem

one dion heats rocessay, jem number before each comment.

ABNOR

MAL

18, HEAD. FACE, NECK, AND SCALP

19, NOSE.

20. SINUSES

21. MOUTH AND THROAT

22. EARS- GENERAL (Int

23. DRUMS (Perforation)

24. EYES— GENERAL (Visual

acuity

and

under items

59,

refraction

60 and 67)

25. OPHTHALMOSCOPIC

26.

PUPILS (Equality and reaction)

27. OCULAR MOTILITY (Associaled parallel more.

ments, nystagmus)

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

(Hemorrhoids, fistuige)

"Prostore, If indicales)

33. ENDOCRINE SYSTEM

LENCLOSURE

34. G-U SYSTEM

35, UPPER EXTREMITIES

(Strength, ronge of

34.

Atrophy of left testis, NS.

36. FEET

37. LOWER EXTREMITIES

(Except feet)

(Strength, range of. motion)

38. SPINE, OTHER MUSCULOSKELETAL

39.

IDENTIFYING BODY MARKS, SCARS, TATTOOS

40.

SKIN. LYMPHATICS

* 39, 1/2" horizontal scar, left side of forehead, WHNS.

_*.

_x

-

41. NEUROLOGIC (Equilibrium lests under item 72)

TERO»

42.

PSYCHIATRIC (Specily any personality deviation)

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

• VAGINAL

• RECTAL

(Coritinue in item 73)

MAR 1 9 1960

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

REMARKS

AND

ADDITIONAL DENTAL

DEFECTS AND DISEASES

0- Restorable teeth

|-Nonrestorable teeth

R

2

31

30

29

28

27

X-Missing teeth

XXX-Replaced by

dentures

>0

10

26

25

24

23

11,

22

12

21

(8 X 8)- Fixed bridge, brackets 1o

include abulments

L

13

20

14

15

E

Type 3., Class 2.

REC-137.

Pot-

494012

LABORATORY FINDINGS

45. URINALYSIS: A. SPECIFIC GRAVITY

B. ALBUMIN

Neg

C. SUGAR

Neg

47. SEROLOGY (Specity lest used and result)

1.020

46. CHEST X-RAY (Place,

D. MICROSCOPIC

CAFB, Tex

Within normal limits.

103-4181101

48. EKG

49.

BLOOD TYPE AND

50. OTHER TESTS

RH FACTOR

Numbered

film number and result)

28 Pent 634,

1403

- Negativ

Cardiolipin - Negative

Atchd

-

APP 2

normal

JAMON

DocId: 32285022 Page 2

---