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74. wotia (Continued) AWD SIGNIFICANT OR INTERVAL HISTORY
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74. SUMMARY OF DEFECTS AND BIAGNOSED (Lac! dragnese: wil dom mumders)
7S, RECOMMENDATIONS—FURTHER SPECIALIOT EXAMINATIONS. InBICATER (Specvfy)
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7B. TYPED OM PRINTED MAME OF PHYSICIAN
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SiSmATURE
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CARL L, HANSEN, Lt Col, USAF, MC-7S
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VACMED GHEETE
Wu. a. GOVERNMENT Parerinad GFPICE, 1087 O-aRLESS
BEST AVAILABLE COPY