80

NO.,
AGE, SEX

2

Wicut

past

Reseed

HISTORY

INJURIES

CENTIMETERS

Blind in left

lo

TS M

eye. Right eye
fair.

34

Mencpause-hys-

126

55 F

cerectomy ‘49,
Pare. la, grey.

BLOOD PRESSURE
HEART

&

ABDOMEN

LUNGS

110/64

Pulse 60, reg.

106/TO

10. Pain in lege.

rExt

Ga or Gyn

Rt

+ catarect
nyeeS apbaxie.

Preetate 2+,
firm left lobe.

Arcus 4». Left

|Mid-Lline surg.

pterygium. At.

|ecar. Erosion

pingueculae.
of cervix.
l+ retinal sclerb

SKIN

Mumercus nevi
on shoulders.
Pigmented moles

pack and neck.

ost,

35
23M

125 '52

110/60 '62

134

115/60

146

120/76

%6

18 M

37
3M

x9
es Fr

40
39 M

ua
Sk M

‘3

76 F

45
he F

Fistula in anc

(corrected gurgically '64).
Low back pain.

peccyoue: vim
4

vb

» Grey.

&-

Menerche
13.
IMP 3/7/64. Pare.
ll, grav. 9. Low
pack pain.

Menarche age 13.
IMP 2/5/64. Pare.

6, grav. 3. Pain

55
as M

legs and arms.

Bilat. pingueculag.
Sl. rowughening

Corneal scar

90/60 '62

left eye '63.

125
115 '63

110/70

Arcus 2+.
Pingueculae and
exophorisa.

1236

110/70

and pig. back cr

neck. Pig. var.

and el.hyperpig.
dorgum right
foot.

Fistula in ana
[with perirectal
abscess '53,
Leukoplakia '63.

Dermatitis
right hand.

wore

Grade I sys. a.

inal arterioaclercets. Circum>
papillary ring of
choroid degenera+
tign.
|

Bate: Rene
:

Throat slight

inflammation.

4

Arcus 2+. Left
pingueculas.
Right pterygius.

LLT

120/70

135

110/Te

Tarcat slight
inflammation.

166
3T 63

96/6e

:
Rt. paramedian
Throat inflamed.| ecar. Severe lat/ Pig. macs.

cervical tears,

in joints, obese
4 URL.

Menarche age 17.
Pare. 2, grav. oO.
WP 3/7/64.

Deckpain. Blindness, partial.

both sides cf

ix} cm. cervical|
erceicn.

185

4a M

35 F

back, abd.,

Arcus 1+.

109 "62

a

unknown. Para.

50

$1

TMnee circinata

inflammation.

Arcus J+. 2+ rete

18K

25 F

ity right index
finger.

lump right arm.

at

49

Traumatic deform-

Throat slight

39

13s 162

120/70

Arcus 3+. Scar

Scars on upper

nose septum.

rt. arm (not
“heta burns” ’.

90/60

100/65
Pulse 86, reg.

neck, ACF.

Healed cervical
Mole on
abdomen.
tear. Bartholin
eyut left labia. |
4+ arcug. Blind]

partial.
Throat
inflamed. Hode

Prostate

lart neck,

Cataract 9D) 164

A

op)

4

,i+.

r

|

__.

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