64
—

NO.
AGE, SEX

PAST
HISTORY

INJURIFS

WEIGHT
POUNDS

BLOCD PRESSURE
HEART AND LUN7S

EENT

APDUEN
GU Ch SYN
eg

ho

36

M

Deformity rt.
forefinger

-—~

hl

51

M

inguinal region

Sear, left

120

4S

349

~=*F

46

8

M

9

22

F

Asthma

10),/68

le
sk

10),/66

i rt.

Tachycardia

99 1/2

1t.

foot

120/80

Cervie
lacera
endoc,

Residual rt.
hemeplegia,

1-2 toe rt.
foot missing

3 previous

scar rt. supra-

heart. block

abortions

clavical area

129

220/66
Arteriosclerosic
heart diseases
aortic stenosis
insufficiency
broaycardia

156

Bilateral cataractse4+ retinal

arteriosclerosis

96/66

obese

Gynece

2 mo. 1eck

‘ay

ingus

50

51

4M

51

32

F

5e

63

F

55

82

M

56

7&

F

Bilateral hallux

182

116/80

Episode abd.pain?

9

11%/60

Pain rt. shoulder

107

104/72

valgus

obese

Nittelschmerz

13k

114/70

107

140/70
aortic insuffi-

Subcutaneous

F

masses both
hips

rae

as

ge

2+ ret. arteriosclerosis

Bilateral cata-

racts light per-

ception only

ciency

57

lt.

i

a!

wa

130/79

Bilateral cataracts

*k

Moucral

gynecos

8
‘ace

Oe

eas

Mt,

Select target paragraph3