ne
PRIVACY ACT MATERIAL RE
MOVED
MEDICAL EVALUATION
This is to certify that I have determined that Eberline
-_
Instrument Corporation employee,
has no unusual medical conditions or physica] impairments
that would limit his normal duties of employment.
Base Line Blood Counts:
White Cel] with Differential
Hemoglobin DfNormal
Date
S/inph
MK Normal
// Abnormal
/7Abnormal
hysician's,
Please type:
William J. Mitchell, M. D.
Signature Name
8100 Constitution Pl., N. E.
Street and No.
Albuq., New Mexico
293-1616
PRIVACY
RIAL
ACT MATE
REMOVED
87110