Xe *RIVACY ACT MATERIAL REMavED . MEDICAL EVALUATION = * This is to certify that I have determined that Ehertine Instrument Corporation employee. 7 _ has no unusual medical conditions or physical impairments that would limit his normal duties of employment. Base Line Blood Counts: White Cell with Differential //Normal // Abnormal Hemoglobin iFNormal f/ Abnormal + Mee Please type: Effie E. G. Medford Signature Name City #304 sh Telephone pRIVACY AG T MATER! AL REMOVED ico 87106 % State 0 ” ab age erie tbeSE TS 201 Cedar St SE Street and No. MD