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78. mores (Continued) and S100 1FICANT OR INTERVAL WiIETORY

Using beta-gamma survey meter MI-5, background reading .03-.06 mr/hr. No radioactive
contaxination found.

+

(Use additonal has if nareesary)
74. SUMMARY OF DEFECTS AND BinewosED (Leet dragness wth item Rumbers)

FS. RECOMMENDATIONS—-PUNTHER BPECLALIOT Examinations impicaTED (Specify)

76.

& PHYSICAL PROFILE

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76. 1F MOT QUALIFIED. LIST DIGQUALIFYING DEFECTS @Y ITEM NUWBES

78. TYPED Of PRINTED MAME OF PHYBICIAR

SIGWATURE

GO, TYPED O8 PRINTED NAME OF PHYSICIAN

SIGNATURE

G1, TYPED Of PRINTED MAME OF DEWTIFT Of Prysician (Iadsaste which)

SIGNATURE

02. TYPED OF PRINTED MAME OF REVIEWING OFFICER OA APPROVING AUTHORITY

SiGNaTURE

CARL L. HANSEN, Lt Col, USAF, MCPS

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NUMBER OF AT~
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UM. @. GOVERN WiaT PAINTING OFFICE. 1887 O—ebEROE

BEST AVAILABLE

COPY

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