1 a mem sf a eaen _. ~ _ - “ 34. ADDITIONAL REMARKS (Show tiem number to which extended entry applies. . . ene _ fy : wae . 2s 4qie : . ~ + ~ . Group all continuations of a particular item) tee, eee mo a Da ae . ‘ ‘ . rt ee - : “abe INSTRUCTIONS FOR ITEM 23: Enter primary cause of admission first, followed by additional diagnoses present in order of importance; then by later diagnoses in chronological order preceded by dates made. Number diagnosis in order. Record fully—including causative agent, how, when, where, doing what, for injuries—in accordance with separate directives. For all diagnoses established by pathological findings, so state. Each chronic condition must be indicated as either “PR” (previously recorded) or “Not PR.” Similarly, any other condition which has been recorded in a previous admission will be so indicated, showing the previous diaprosis.” In all cases designatéd as previously recorded, show place, date, and register number of previous admission. Every condition that existed prior to service will be indicated as “EPTS.” Diagnoses of venereal disease and malaria will be characterized either as “EPTS” or as ‘“‘Not EPTS.” In the case of diagnosis from which recovery occurs prior to disposition of the case, a date will be shown, thus: ‘Recovered, 11 May 1951.” For each diagnosis line of duty status must be shown in accordance with separate directives, thus: “LD, No, EPTS,” “LD, No, Misconduct,” “LD, Yes, EPTS, Aggrevated by Service,” ete. 35. CAUSE OF DEATH THIS DOES MOT MEAN THE MODE OF DYING, 1a, DISEASE SUCH AS HEART FAILURE, ASTHEMA, ETC. IT MEANS DEATH THe DISEASE, INJURY, or COMPLICATION. WHICH CAUSED DEATH - : ~ [TSA (De nor enter : . cause per line . bande} . CONDITION . - DIRECTLY LEADING . ee a | - ot PED : TO INTERVAL BETWEEN ONSET AND DEATH . . . . * i ~ * . ww ~~ . rs Lm , “ 1 ANTECEDENT CAUSES for items fa, . i. pee ro 4Onae the consequence of) Y: more than one - OR - . ‘ . . : an | | MORETD CONDITIONS, IF ANY. GIVING, RISE TO THE ABOVE cause fitem Ia) STATORG THK UNDEIR- ¢. THIS MEANS CONDITIONS CONTRIBUTING TO THE DEATH BUT NOT RELATED TO TRE DISEASE OF | CONDITIONS CAUSING DEATH. Tl, LYING CAUSE LAST. . ‘DDE To (OF as the consequence of) . | OTHER SIGNIFICANT CONDITIONS — _ Aa a 34. AUTOPSY PERFORMED (ff ‘Yes’ indiagte dase and place 37. HOUR AND DATE OF DEATH r be 38. EXACT PLACE OF DEATH | 39 ~ ' | ° ~ af ty ~ ri SIGKATURE @F PMESICIAN _ n/m dette D —_ . : bey ome me ak ou Ehe r- 7 . , ut A. COVER CPF6 errr meee te