Document YGeZbJQnaD4Lw8LqkBEvqLnbE

WEINZIMMER CLINIC 1211 South Cicero Avenue PHYSICAL EXAMINATION Company. Applicant/ At Emplo R e-em p lo rnc n t Examination Re-ex aminadon Previous Injuries, Operations or Diseases / Name Address Height Deformities from Injuries or otherwise VISION Without Glasses Right Eye 20/ Left Eye 20 S Weight Date. _ Wo frk Age Marital Status f Vaccination: Urinalysis: Reaction REMARKS: Physical Grade, A____b JJ^C______ Best ultimate grad Signed in presence of Medical Examiner Employe* Grui>hie Buainne Purm*-- Defects correctable bj Signed CONFIDENTIAL INFORMATION CYWI 4-001356 \3 3 5 Ji SB ** CYWI 4-001357