124 "O., WEIGHT PAST — aE, SEX HISTORY eee ON JUR LES CENTIMETERS BLOOD PRESSURE HEART & LUNGS ABDOMEN EENT Gu or Gyn SKIN 1055 iF 1056 Aaah # 105T LF 1058 LM 1503 6M 1504 2M Seres on nostrils; no hx. of sig. '64 Polio (1) date?; no sig. Sistory aside from leg pains "6b 15# No a 3-1/2 #| Nom 30-1/4 96.1 2801/4 85.2 78/58 Gr I apical sys Scars a Gr I apical sys m pe 1M