SECURITY CLASSIFICATION

JOINT MESSAGEFORM
PAGE.

ROTTER OR

04 ..06

aS

LMF

PP

UNCLASSIFIED
CLASS

cic

FOR MESSAGE —_Ke_“«_

UUUU

BOOK

062227z MAR| 80

MESSAGE HANDLING INSTRUCTIONS

MILITARY

OTHER

TOTAL]

(1)

VISITS

4

12

16

(2)

REFERRALS

0

1

1

(3)

EVACUATIONS

0

0

0

(4)

LOST TIME ACCIDENTS

1

0

1

NOTE:
A.

ACCIDENT::

A USNE E-5 RECEIVED A ONE-AND-A-HALF INCH CUT ON BACK

OF HIS HEAD RESULTING FROM A FALL.
B.

MEDICAL REFERRAL:

REQUIRED FIVE SUTURES.

MARSHALLESE WOMA'N WAS REFERRED TO KWAJALEIN

FOR EVALUATION OF CHRONIC CHEST AND ABDOMINAL PAIN.
B.

CUMULATIVE LOST TIME ACCIDENTS SINCE BEGINNING OF PROJECT:

6.

LOGISTICS SUPPORT:

A.

SHIPMENTS:
SURFACE

(1)

M/T RECEIVED

25

0

(2)

M/T SHIPPED

21

0

B.

PASSENGERS IN:

7.

ATOLL POPULATION

.

15; OUT:

JTG STAFF

107

10

_

DISTR:

ORAFTER TYPED NAME, TITLE. OFFICE SYMBOL. PHONE & DATE

SPECIAL INSTRUCTIONS

ec

TYPED NAME. TITLE. OFFICE SYMBOL AND PHONE

4

SIGNATURE

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DD

ad

SECURITY CLASSIFICATION

tas
FORM

1D0EC 70

1 73

REPLACES PREVIOUS EDITION WHICH WILL BE USED.

.

UNCLASSIFIED
stv U.S.GPO:1975-0-572-965/71

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AIR

65

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