7.

Occupational History:

Professional or office

|

Light work (sales or trade)

Factory

Food handling

Farming

Health services

Mining

Retired

Custodial

Carpentry

Electrical

Military.

Heavy equipment

|

Other

Remarks *

(*Explain occupational experiences that may have involved periods of exposure to
radiation, chemicals, dust, etc., at levels above those normally expected for the

’ average population.)

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