MEA 1, agent B2. waient $3. COLON WAIA 3 AND OTHER FINDINGS $4. COLON tyes G8. suid. O86. Tewereatuss D SLANDER o7. QLooe PReasune (dem af hewrt level) a eirtine Se. #v6. Ong s. arcumGENT bat! avs. OLSTANT WIION RIGHT §O/ CORR. TO BOs TORR To pos ove Granbing (3 en.) bias LENT zoe oe. «. oO etoiue i me ave D oaret PuLeE (Arm af Asart inal) A. airtime o. arraa axtecie ¢. 2 win. artece ©. MECUMDERT E. AFTER ranging 8 wank. Dias. eo. REFRACTION or i €!. WEAR Vision 5. ox ConA. fo td a. on coma. To ev 2. urtenornonia (Spenly duttance) as? 6s. Ex? On, ACCOMMODATION in Prise oY, PRisu Cony. et a 04. cove a vision (Test used and rerull) OS. hom peern pracertion ag 66. FIELD OF Vinton 67. ment vision (Tast used ond score) 66. GED Lene Tem 70. TI. RIGHT ) ° veLOnnetTeo Ler comanctee MEARING RisHT ay fia av fe Ler wy fit oy sit AUDIOMTTER 2H0 R56 teo ste tooo 1084 go00 $048 G9. WTRAOCULAR TENsion TZ. POTCHOLOEICAL AND PSYCHOMOTOR (Teste asad end score) soce #804 scoo s08 soe lai gone O2a8 Q1geT REPT 74. wotia (Continued) AWD SIGNIFICANT OR INTERVAL HISTORY Using beta-camma survey meter MI-5, background reading .03-.06 mr/hr. No Radioactive eontaminaitien found, (Uoe additional sheate (f necassary) 74. SUMMARY OF DEFECTS AND BIAGNOSED (Lac! dragnese: wil dom mumders) 7S, RECOMMENDATIONS—FURTHER SPECIALIOT EXAMINATIONS. InBICATER (Specvfy) 78, A. PHTBICAL PROFILE ® u L * c s 77. examines (Chack) a. Chae guativice ron 6. Is MOT QUALIFIED Fo® BG. PHYBICAL CATEGORY 70. tf MOT QUALIFIED, LIST DISQUALIFYING DEFECTS BY ITEM @UNSER 7B. TYPED OM PRINTED MAME OF PHYSICIAN a ' e £ SiSmATURE ‘ CARL L, HANSEN, Lt Col, USAF, MC-7S O06. TYPED OA PRINTIO HAME OF PHYBICIAN srenaTuar Ol. TPES Of PRINTED waME OF DENTIST Of PHTBICiAN LFmchonde whack) Siematyure B2. TYPED OF PRINTED HAME OF REVIEWING OFFICER ON APPROVING AUTHORITY BIGNATUAE WUMBTA OF ate VACMED GHEETE Wu. a. GOVERNMENT Parerinad GFPICE, 1087 O-aRLESS BEST AVAILABLE COPY