Document k94EkKDvBbaonMZd35LZ8neZJ

ru 0 P Y N a me De pt .. Div . o r Wo r k s: (FOR CONFIDENTIAL USE! OF MEDICAL DEPARTMENT) M E D IC A L E X A M IN A T IO N SOCONY - VACUUM O IL COMPANY IN C O R P O R A T E D Service Station ___________________ _PA_o_p_ps_li_ti_ei _od_n_f_o__r _:____S__a_l_e__s_m__a_n________ d a t e : Ho V. lU , 1 9 3 5 Co u n t r y o f B ir t h : Se x : ^ale color : d a t e o f Bir t h : I 90I a g e: 29 B sOuOffaTlTgos.t Aye* I'T .Y ,_______________ S i n g l e : y .. L g s Ma r r i e d :______ W i d o w e d :__________ D i v o r c e d :__________ H IS T O R Y O p : TUBERCULOSIS. PNEUMONIA. ORGANIC HEART DISEASE. NEPHRITIS. DIABETES. RHEUMATISM. SYPHILIS. GONORRHEA. Me n t a l D i s e a s e . E p i l e p s y , o r O t h e r S e r i o u s S i c k n e s s e s ( d e s c r i b e , c i v i n q d a t e s a n d d u r a t i o n ) _________ J ______ _______________________ Operated to n s ils and adenoids in childhood S e r io u s In j u r ie s o r O p e r a t io n s : (d e s c r ib e ) : U s e o f ALCOHOL: Ha b it F o r m in g Dr u g s : U s e o f To b a c c o : S m a l l po x Va c c in a t io n : . In t e l l i g e n c e : HOttnal MOUTH: EYES: Vis io n . R. 2 0 / 1 0 G e n e r a l Ap p e a r a n c e : H e a lth fu l p h y s i c a l A g e : 2 9 H e i g h t : 5"7 W e i g h t : 7 - 5 5 T e m p . :3 2 . 6 Te e t h : L . 2 0 / 9O To n s il s : No s e : Under treatm ent, "hit u n corrected W it h Gl a s s e s . R. 2 0 / L. 2 0 / : Dis e a s e : EARS: He a r in g . R. L. Dis e a s e : CIRCULATORY: H e a r t . S iz e : P u l s e Ra t e : Ar t e r ie s : Mu r m u r s : Bl o o d P r e s s u r e : S y s t o l ic : Dis e a s e : 13^ Dia s t o l ic : 70 , LUNGS: Re s o n a n c e : Dis e a s e : Ra l e s : C h e s t Me a s u r e m e n t : Ex p ir a t io n : . In s p i r a t i o n : G A S T R O -IN T E S T IN A L : DISEASE EXTREM ITIES: D i s e a s e : He r n ia : H e m o r r h o id s : De f o r m it y / Uppe r Ex t . : 1 Lo w e r Ex t .: Ap p e n d ix : Va r ic o s e Ve in s ; BACK / Uppe r : 1 Lo w e r : Ul c e r s: NERVOUS SYSTEM: S t ig m a t a o r Dis e a s e : Ref l ex es Ar g y l -Ro b e r t s o n : S pin e : . Romber g : Fl a t Fe e t : ` .. Tr e m o r s : ENDOCRINE GLA ND S: G EN IT O -U R IN A R Y : URINALYSIS; ALBUMIN: Sugar : Ca s t s; Sp . Gr . Va r ic o c e l e : Ve n e r e a l o r Ot h er Dis e a s e : -ABORATORY T ESTS: Wa sh er ma n : S pu t u m : X-Ra y : -YMPHATIC SYSTEM: KIN (SCARS. TUMORS. DISEASE) : Me n s t r u a l H i s t o r y . o f i n d ic a t e d ) : s u mma r y - * ls'"maa was r e j e c te d on; the co n d itio n o f th e ^ e y e s d n O c t . l s t , 19 35 and-a d v ised '----------- ` c o n su ltin g 'a' s p e c ia lx s t l S^r^shseTiEfenown'reason-he has -been" woTicingr^ad i t i s -- _________ my ad vice th a t he he dropped from th e se r v ic e im m ediately "because o f the serio u sn ess r f o f the e y e s . Under no circu m stan ces should he he a llo w ed to ` 1 ^ IATING: 1A IS 2 3 A d riv e a car "belonging to th e company. . Hbraaaination ITov.lUth, 1935 if) oc F o l l o w In s t r u c t i o n s o n F o r m p -M -4 " In f o r m a t io n f o r Ex a m in in g P h y s i c i a n s .- over- z* ! 1 ; ; ; S ig n a t u r e : 3 n ^ l in g h am (MEDICAL EXAMINER) jS M 'k '- 4**1 *. y i- M :w - > .T M O V i: - '< .: *: : v ? i i . s ! * '- :. l ; < _ - show s-that "th e 'e y e c o n d itio n under expert treatm ent has not improved, hut .rather has become worse.' J The c o n d it io n - is in no way r e la te d t o - h is occupation, hut i s probably- of a system ic o rig in r ii^ r -:--. v, ,, This maa` th e care o f a r e lia b le ; p h y sic ia n , Dr.'"Harry, Weed has made a thorough 'examination o f th e e y es and advises" th a t le n s e s w i l l in no way a id ' h is v is io n ; b u t g iv e s a very grave prognisi'iV'.'!'Atrophic c o n d itio n o f both . c p t ic : n e r v e s.-- .................- - Dr.\.Thomas "Walsh i s making a complete" stu d y o f th e p h y sic a l c o n d itio n o f t h i s man, and a rep ort w i l l fo llo w l a t e r . :V, V;:\a = iUitti'i.u*. V '-: 'c; ' - - .'. -'." V v irs:! - " 1 .............. ....... V--'- i.:Z W. B. Burlingham, M.D, r t . n\ ' ' ~ >4 J -' - ' ' ...... -. i ..: - . o f ' . - ...... 5 . - -*-;s . . . . ___ l~~?~ " ' 1________ ___ ______ _____ _.. . ------- - -- _ ..................... : ' O f e . 'iO S>?B Cf3'T?8'^' bMEr.*C > . _______ _______ - ' ___ . - V V- - ~ __ '* ' j a-* ' ' . 'r sfev "" * * .*_ * . . ..... ^ .................... .-i -: zih .. ' ." .. . \ 'S*VsX ' /C 'E ^x O C t.io Ju ` - - ./ U i: OicfcV" ^ - - c o c o ^ ; - /. <' :o :r . K E D i C i r -E X V M r^ y -L n ;: i f e w i i .'CC3>^ T' f 0:1...P4000r;-T '