PRIVACY ACT MATERIAL REMOVED MEDICAL EVALUATION This is to certify that I have determined that Eberline Instrument Corporation employee, > has no unusual medical conditions or physical impairments that would limit his normal duties of employment. Base Line Blood Counts: White Cell Unta Hemoglobin Date tune 26 £7 Norinal 1977 Wow T/ Abnorma] // Abnormal <f FE > Cre , fhe rigsteasSignature Please type: Philip S. Tavlsee, MD, Signature Name 1 = Mi Tydeewna av4 tnh rode Street and No. santa Fe, li, i, City State S7ao 1 L1Tp 2m Si8 elephone D REMOVE PRIVACY ACT MATERIAL