Agency: FBI
Originator: FBI
Document date: 02/23/1956
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

Date:

5/27/201

Identification Form

Agency Information

AGENCY: FBI

RECORD NUMBER :

124-10134-10182

RECORD SERIES :

AGENCY FILE NUMBER:

HQ

67-494012-55

Document Information

ORIGINATOR: FBI

FROM:

TO :

TITLE:

DATE: 02/23/1956

PAGES:

2

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

v9.1

DocId: 32284906

Page 1

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Released under the John F.

Kennedy Assassination Records Collectión Aot of 1992 (44 USC 2107 Mote).

Derrard lot s8017

9

(Rev. Aug. 1950)

PROMULGATED BY

523-50

BUREAU,OF THE

BUDGET

KEPORT OF MEDICAL EXAMINATION

CIRCULAR A-24

1. LAST NAME-

-FIRST NAME-MIDDLE NAME

2. GRADE AND COMPONENT OR POSITION

3. IDENTIFICATION NO.

HOSTY g

James P

Jr.e.

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

5. PURPOSE OF EXAMINATION

10344 Estacado Dr. Dallas,Texas

Annual

6. DATE OF EXAMINATION

23 Feb 1956

7. SEX

8. RACE

9. TOTAL YRS. GOVT. SERVICE

10. DEPARTMENT, AGENCY, OR SERVICE

Male

Cau

MISTARY

CIVILIAN

Dept. 0f Justice

11. ORGANIZATION UNIT

FB 1 6

12. DATE OF BIRTH

13. PLACE OF BIRTH

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

C2824 Chicago, ILl.

ivan.

15. EXAMINING FACILITY OR EXAMINER, AND ADDRESS

USNAS, Dellas, Texas.

17. RATING OR SPECIALTY

CLINICAL EVALUATION

16. OTHER INFORMATION

Catholic

TIME IN THIS CAPACITY: TOTAL

LAST SIX MONTHS

NOTES.- Describe every abnormality in detail. (Enter pertinent item number before each

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

NORMAL ABNOR-* (Check each item in appropriate col-

MAL -

umn: enter'"'N.

if-not evaluated)

25

18. HEAD, FACE. NECK. AND SCALP

19. NOSE

* 34 Atrophied right testicle.'

20. SINUSES

21. MOUTH AND THROAT

(Int. de ext. canals) (Auditory

22. EARS-GENERAL acuity under items 70 and Y1)

23. DRUMS (Perforation)

24. EYES-GENERAL

•(Visual acuity and refraction,

-under-item's 59, 60, and 61)

25. OPHTHALMOSCOPIC

26. PUPILS (Equalit! and reaction)

27. OCULAR. MOTILITY

•Lissnciated parallel move-

menes. nusuadrug

28. LUNGS AND CHEST (Include breasts)

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

30. VASCULAR SYSTEM (Varicosities, etc.)

31. ABDOMEN AND VISCERA (Include hernia)

32. ANUS AND RECTUM (Hemorrhoids, fistulae)

33. ENDOCRINE SYSTEM

34. G-U SYSTEM

35. UPPER EXTREMITIES

(Strenath, range of

36. FEET

37. LOWER EXTREMITIES

(Except

{cet)

(Strenoth range of motion)

38. SPINE: OTHER MUSCULOSKELETAL

39. IDENTIFYING BODY MARKS, SCARS. TATTOOS

XEROX

MAR 1 1 1980

Entered ar Jard

Females only]

40. SKIN, LYMPHATICS:

41. NEUROLOGIC (Equilibrium tests under item 72).

42. PSYCHIATRIC (Specifi any personality deviation)

(Check how done):

'43. PELVIC

• VAGINAL...

• RECTAL

44, DENTAL (Place appropriate symbols above or below number of upper and lower teetì, respectivel?)

!. O.— Restorable teeth

• X. Missing teeth: D::r 127 *-(6.X8).-Fixed bridge, brackets to

%. -Nonrestorable teeth

-- XXX:-Reptaced by dentures

include abutments

Sical CAron 6- 94:012 -551

REMARKS AND ADDITIONAL DENTAL DEFECTS AND

DISEASES

"Pype TIT0745

2-

31,2

- 3--

4 3)

-6 77

30

29

28 .127

26

25

•U""

92101--12:13114

23 * : 22

21

24

20

15 -

. 18

17

Qualifi

45: URINALYSIS: SP.

GR.

ALBUMIN

SUGAR

Neg:

Neg•

48. EKG

1.020

MICROSCOPIC

Normal

49.

BLOOD TYPE AND RH

FACTOR

LABORATORY FINDINGS

46.. CHEST X RAY. (Piäce, date, fumnumber , result)

47. SEROLOGY (Specify test used and resull).

USNAS,

Dallas,

exas: 2-23-56

Film #

737, Negative

Kahn: "egative

50. OTHER TESTS

THREE /

30

АРП 1-7.1056

DocId: 32284906

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## Page 3

Released under the John F. Kennedy Assassination Records Collection Act of 1992

444 USC 2107

Hote).

DATE: 11-14-2017

134-1018

51. HEIGHT

72

52. WEIGHT

209

57. BLOOD PRESSURE (Arm at heart level)

SITTING

SYS. 120

DIAS. 80

RECUM-

SYS..

BENT?"

DIAS.

59.

DISTANT VISION

RIGHT 20/

20

LEFT 20/,

20

62. HETEROPHORIA:

(Specify distance)

_CORR. TO 20/

CORR. TO 20/

"Es®

EXC

53: COLOR HAIR

MEASUREMENTS AND OTHER ENDED A RESHUILD"

54. COLOR EYES

Brown

0B7own1

SLENDER MEDIM HEAVY OBESE

Series

58. PULSE (1rm ut heart level)

STANDING

(3 min.)

120hp sp Ng

82

"765

AFTER EXERCISE

RECUMBENT

18 PROg

4N. AFTER

98. 6

AFTER STANDING

3 MIN,

60! •

BY

BY

REFRACTION

61.

S:

CX

NEAR VISION

CORR. TO.

CORR. TO

BY

BY

R.

H

L. H.""

PRISM DIV.

63. ACCOMMODATION

RIGHT

66. FIELD OF VISION

LEFT

64. COLOR VISION (Test used and result)

Passed

Fatant

67,- NIGHT VISION (Test used and score):

65. DEPTH PERCEPTION

(Test used and score)

*-PRISM'CONV. "

F. 1

UNCORRECTED

CORRECTED

PCT.

PD

68. RED LENS

69. INTRAOCULAR TENSION

70.

HEARING

71.

500

619

1000

1024

AUDIOMETER

2000

2048

72. PSYCHOLOGICAL AND PSYCHOMOTOR (Tests used and score)

3000

8896

4000

1096

8000

8199

RIGHT. WV.

SV

15. /15

LEFT WV 1545 SV: SV:155

RIGHT

LEFT:

73. NOTES (Continued) AND SIGNIFICANT OR INTERVAL HISTORY

No significant history.

"(Use additional sheets of plain paper if necessary)

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

#: 34 Athophied night testicle.

75. RECOMMENDATIONS-FURTHER SPECIALIST EXAMINATIONS INDICATED (Specify)

Wone o

77.

EXAMINEE (Check)

IS NOT QUALIFIED FOR

Annual

Strenuous Physical Exertion.

78. IF NÖT QUALIFIED. LIST DISQUALIFYING DEFECTS BY ITEM NUMBER

-end gan of Tirearms

i *"

79. TYPED OR PRINTED NAME OF PHYSICIAN

F ..

SPURCEON

80. TYPED OR PRINTED NAME OF PHYSICIAN

SIGNATURE

NC-USNR

SIGNATURE-

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

H. J.. BLOQM CDR DC USI

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

SIGNATURE

SIGNATURE

JOVERNMENT PRINTING OFFICE: 1953-0-243413 16-- 62288-1

76.

P.

PHYSICAL PROFILE

PHYSICAL CATEGORY

• C

NUMBER OF AT.

TACHED SHEETS

DocId: 32284906

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