MEASUREMENTS AND OTHER FINDINGS Ol. HkleHT $2. weient 62. CoLom mala 84. co.ca tres $5. Bure. BO TeergmatyEs CD svences 87. BLooe Pressuae (Arm ot Aeori level) a. arrtine $s. avs. ®. Ricuu. 1s. SUNT 1 ave. $a. t. i il hias bist brs. oun.) BiBTART VIBION conn. To a0/ LEFT ror cores To 20/ Oo Have D oness Puise (Afm at Aenrt level) a. GTTTING @. AFTER BRERCIQE C. a MIN. APTAR Bb. RECUMBENT © aPTOR STANDING 2 Bin. Dias. 46. RIGHT 20/ Oo GLoiwe REFRACTION oy #1. hEaAd ViBION e. on CORR. t0 ao t. ox CORR YO er 62. HeTEROPHORIA (Spaaly dentamos) ese 63 . ax* a.n pat ACCOMMODATION MiGHT RIGHT Wy Ler wy Paiste Btv. PRISM CONV. Coal ec #4. cole a vision (Test wed end rerull) 6. few perte PEAcertion sh 67. sient vision (Tax used and wore) 68. QCD Lens Test ’ ao Uncorerctes mr commictéo G6. FIELD OF vision 70. . Lu. WEARS ne Tt. fis ev fis fia ev fu AUDIOMETER ato age foo é1f 1900 1084 zooo go48 G8. WTAAOCULAR TERsion 72. (Taste PRYCHOLOGICAL cn AND FSYCNOMOTO , R gooo 2808 ao60 MOE go00 Bigg coo S198 Rew Lert 73. moTaa (Combnuad) and SIGMIFICANT Of INTERVAL HISTORY e Teing beta--amma survey meter MX-5, backcround reading 03 -.06 ar/hr, No radioactiv contamine tion found, (Vee addional sheds (/ necessary) 74. BUUMARY OF DEFECTS ann GlAgHOSES (Lest dsagnese: Enté tien Sumbers) 75, MECOMMENDATIONS—FUNTMER BPECIALIOT EXAMINATIONS INDICATEC (Specsfy) 76. A. PHYBICAL PROFILE ° u L H E s 77, traminge (CAeak) a. CH) 6 quacirits fon e. Cis not ovatirice rom B. PHYBICAL CATEGORY 74. UF MOT QUALIFIED. LIST DISQUALIFYING DEFECTS BY ITER BUNEER 79. TYPED O8 PRINTED MAME OF PHYSICIAN OG. TYPED Oh PAINTED MAME OF a PHYsiCiaN . FS - a 8 e £ SIGNATURE SIGNATURE 61. TYPED OR PRINTED NAME OF DENTITT OF PHYSICIAN (Imchemie whack) GISMATURE B2. TYPED OR PAINTED NAME OF REVIEWING OFFICER OR APPROVING AUTHORITY GIGHATURE NUMBER OF AT= TACHED GNTETS WU. Bh. COVEAN WENT PRINTING CPFICE: 187 O—snngee BEST AVAILABLE COPY