Agency: FBI
Originator: FBI
From: DL
Document date: 02/21/1961
Document type: PAPER, TEXTUAL DOCUMENT

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Released under the John F. Kennedy 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 : 124-10134-10259

RECORD SERIES: HQ

AGENCY FILE NUMBER :

67-494012-97

Document Information

ORIGINATOR: FBI

FROM:

DL

TO:

TITLE :

DATE: 02/21/1961

PAGES:

6

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 FD-300, MED RPT

v9.1

DocId: 32284983

13

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Réleased under the Jon F.'Kennedy Assassination Records Collection Aot of 1992 (41 USC 2107 Hote) .

DATE: L1-14-2017

fandard form 88

June lydi

81-202.01

LAST NAME-FIRST NAME- MIDDLE NAM

Hosty

James

P

Jr.

LA. HOME ADDRESS (Numbor, street or RFD, city or lown, zone and State)

"PORT OF MEDICAL EXAMINATION

2. GRADE AND COMPONENT OR POSITION

Special Agent

5, PURPOSE OF EXAMINATION

3. IDENTIFICATION NO.

7392

6. DATE OF EXAMINATION

11018 Genetta Dr.

Dallas 28,

Texas

7. SEX

8. RACE

Annual

10. AGENCY

Male

White

9. TOTAL YEARS GOVERNMENT SERVICE

MILITARY

3

CIVILIAN

9

12. DATE OF BIRTH

13. PLACE OF BIRTH

21 Feb 61

11. ORGANZATION UNIT Dallas, Texas

Dallas

28

Aug

15.

24

( 36)

Chicago,

Illinois

EXAMINING

FACILITY

OR EXAMINER. AND ADDRESS

USAF HOSPITAL, CARSWELL, CAFB, TEXAS

17. RATING OR SPECIALTY.

Janet P. Hosty (Wife)

Same as Item 4e

16. OTHER INFORMATION

TIME IN THIS CAPACITY (Total)

LAST SIX MONTHS

CLINICAL EVALUATION

NOF

MAs

(Chart each

"NE"

urk.rruate

column,..

NOTES.

/ Dosaribo

Lestibe in erm

ABNORE

number before each commont.

ner pronunico.

18. HEAD. FACE, NECK, AND SCALP

19. NOSE

120.

SINUSES.

21.

MOUTH-AND THROAT

22. EARS- GENERAL (Int.

a. aft. canals

(Auditor

acuily under items

70

and-71

23. DRUMS (Perforalion)

24, EYES-GENERAL

retraction

60 and 67)

25. OPHTHALMOSCOPIC

26.

PUPILS (Equalily and reaction)

27. OCULAR MOTILITY (Associored parallel mora.

ments, nystagmus)

LUNGS AND CHEST (Include breasts)

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

30, VASCULAR SYSTEM (Varicosities, elc.)

31. ABDOMEN AND VISCERA (Include hernia)

-

x

X

32. ANUS AND RECTUM

(Hemorrhoids, fistulan

(Prostate,

if indicated)

33. ENDOCRINE SYSTEM

34. G-U SYSTEM

35.

UPPER EXTREMITIES

(Strength, range of

motion.

3 ENCLOSURE

36.

FEET

37. LOWER EXTREMITIES (Except feet)

retrendth

range of molion)

x

x

SPINE. OTHER MUSCULOSKELETAL

67-494

Searched

018mm

Nanibared

39.

IDENTIFYING BODY MARKS, SCARS. TATTOOS

40. SKIN, LYMPHATICS

41. NEUROLOGIC (Equilibrium tests under item 72)

39.

i horizonte sear,

42. PSYCHIATRIC (Specify any personality deviation)

43.

PELVIC (Females only) (Check how done)

[7 VAGINAL

• RECTAL

(Continue in item 73)

44. DENTAL (Place appropriate symbols abore or below

number of upper and lower teeth, respeclively.)

REMARKS

AND ADDITIONAL DENTAL

DEFECTS AND DISEASES

, O- Restorable teeth

1-Nonrestorable teeth

R

2

31

X-Missing teeth

XXX-Replaced by dentures

(6 x 81- Fixed bridge, brackels 10

include abutments

30

29

28

27

26

25

24

10

23

11

22

13

14

15

Type 3, Class 1

20

19

18

45. URINALYSIS: A. SPECIFIC GRAVITY

B. ALBUMIN

Neg

C. SUGAR

Neg

47: SEROLOGY (Specify test used and result)

1.026

D. MICROSCOPIC

48. EKG

12

21

LABORATORY FINDINGS

46 CHEST X-RAY (Place dale, film number andy o

CAFB, Texas 21 Feb 61

#61-3201

49. BLOOD TYPE AND

50. OTHER TESTS

RH

FACTOR

Negating 1 1 1980

Cardiolipin Negative

Attached

-

(//normal

MAR BAI

10€

DocId: 32284983

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