_ - PRIVACYACT MATERIAL RE s MOVED KEDICAL EVALUATION ‘t ? . wo This is to certify that I have determined that Eberline Instrument Corporation employee, “> has no unusual medical conditions or physical impairients , that would limit his normal duties of employment. Base Line Blood Counts: White Cell with Differential Hemoglobin Date f ff formal 0-31-97 //formal // Abnormal, // Abnormal see ata-ched revert hitdf (Zt, 20 | Physician's Signature Please type: w+ 7 ~»> Lee =. ae ~~ 3 28 Signature Name tier gre, 4. 0. das , 1 tN "999 Frivviaw Street and Ho. "eranecla, Nev wastes City State: Zip ROS) FRR. 4A Telephone RIAL REMOVED PRIVACY ACT MATE PRA