esbesach or Te xfan : ys “a ok | flout Nee Teeot aS «a * at e ; nage t R wats + : | aes ae te . . n pewmaat wi x . in » a » - we . es - . - ‘ s . 7 hie To fa. a? AOSORS a Tennent DISPOSITION FORM PRIVACY ACT MATERIAL For use of this form, see AR 340-15, the preponent ogency is TAGCEN. REFERENCEOR OFFICE SYMBOL en Re ~~ © ; . st REMOVED SUBLECT HST-PE Results of Medical Examination 4 ars . FROM (Joint Task Group Enewetak ) C, Physical Exam Section? ATE ,TAMC APO SF Results of medical examination for (Name) a. Physical Profile: b. Physical Category (Alphabetical Code) c. Age qd. Height e. Weight MAA® Pounds. f. Glasses g@. Date of most recent periodic medical examination Gk: ae h. Immunizations up to date i. Date eye examination completed 3. Normal complete blood count with differential k. Individual is/iswret fit for Enewetak duty. A A~ L H E i> /* S K . . Ft MZ é> Yes In. Rida bation wed U (SSN) = sgt Mig able AOL, & ~ (Rank) P cur | 96438 No. ? A Yes 25 No. g baccot “2 2 . ad Yes No. SF? Ue WILLIAM F. RUSCHHAUPT, III, M.D. MAJOR, MC Chief, Physical Exam Section o papery 5ete a na awe et TO Commander PRIVACY ACT MATERIAL REMOVED ee eS ates ARE Tr eprate ime eee meme ret . “howl