| 4% | La in dR Hs fo Pes (jeerna ve >> PRIVACY ACT MATERIAL REMOVED ! 7 MEDICAL EVALUATION This is to certify that I have determined that E5erline re et ok _. Instrument Corporation employee, has no unusual medical conditions. or physical-iraairments that would limit his normal duties of employuent. Base Line Blood Counts: , G toe _ _ White Cell with Differential PXNormal 77 Abnormal Hemoglobin ~~ Normal Date (, -2C -)7# : it -77 : CL \-~ce Ww) ; /7 Abnormal _ !* ‘ wvk S “I Kia Physician's Signe*ure Please type: _E. M. Sager, M.D. Ce -€_ OWNS ic SJ Signature iiama \ Yul C me \ yb iw va . . Street and iio. CL ee wa we owe City ptate J A Plt Zip SUgs- 29% -2 46) Telephone : PRIVACY ACT MATERIAL RE MOVED \ — Mée=- 2ie o . .