80 WEIGHT NO., AGE, PAST SEK 29 HISTORY etewe INJURIES CENTIMETERS} BLOOD PRESSURE HEART & ABDOMEN LUNGS EENT 110 75 2 M Blind in left eye. Right eye air fair. 110/64 Pulse 8, reg. 34 Menopause -hys- 126 106/70 1e5 '62 110/60 '62 134 115/60 146 120/70 Arcus 1+. 90/60 '62 Corneal scar left eye '63. terectany "hg, Para. 14, grav. 10.Pain in legs. 55 F Gu or Gyn Rt hyper“mature Lett aphakia. ; ‘ . Prostate 2+, firm left lobe ' Arcus 4+, Left |Mid-line surg. pterygium. Rt. |scar. Erosion pingueculae. of cervix. 1+ retinal ecler+ osis. SKIN Numerous nevi on shoulders ‘ Pigmented moles back and neck. 35 23M 36 . 18 M 37 30 M 39 - 109 "62 25 F ho Fistula in ano Traumatic deform- gically '6h). Low back pain. finger. (corrected sur- 39 M 42 Lump right arn. 54M ity right index Throat alight Tinea, circinata inflammaticn. pack, abd., legs and arms. Bilat.pingueculae. S51. roughening and pig. back of neck, Pig. var. and sl.hyperpig. dorsum right foot, 125 115 '63 110/70 116 110/70 68 130/72 Arcus 2+. Pingueculae and exophoria. Fistula in ano |with perirectal absceas '63. Leukoplakia '63. Dermatitis right hand. Arcus 3+.2+ ret? inal arteriosclerosis. Circump+ papillary ring of choroid degeneraP tion. Menopause: time 43 unknown. Para. h, ? grav. 4, 76 F 45 Menarche age 13. 42 F 11, grav. 9. Low LMP 3/7/64. Para. 18 M Menarche age 13. IMP 2/5/64, Para. 6, grav. 3. Pain hg 25 F 4h M 51 Menarche age 17. 35 F Para. 2, grav. 0. LMP 3/7/64. 55 Backpain, Blindness, partial. 85 M cataracts Throat slight Arcus 2+. Left 117 120/70 135 110/70 Throat slight inflammation. 166 137 '63 96/64 Rt. paramedian Throat inflamed.| scar. Severe lat] Pig. macs. cervical tears, both aides of in Joints, obese, URI. 50 Bilet. pterygium Bilat. inflammation. back pain. AT c Grade I sys. m. pingueculae. Right pterygiun. 1x3 cm. cervical| erosion. 185 120/70 99 90/60 Arcus 3+. Scar mf. 3 rt. arm (not "beta burns"), Healed cervical tear. Bartholin 100/65 Pulse 86, reg. 4+ arcus. Blind, partial. Throat inflamed. Node left neck. Cataract OD) _.¢4 Aphakia 0D} 5 0 L bey Sears on upper nose septum. cyst left labia. 134 61 neck, ACF. Prostate 1+. Mole on abdomen.

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