Document mpXgVzwj16gVynB8R8pEZ1B4Q
o
*
The bronchovascular markings are unusually prominent and there are irregular, nodular densities, :in both lungs, especially on the right. The lung roots, are-larger than normals Diaphragmatic adhesions are present on both sides. These changes have developed gradually over'the years from "normal" in 1953 - therethas been definite further changes since the last film.V'The appearance of this film suggests a mixed exposure to asbestos and to silica. An occupational history is needed to make a diagnosis more certain, but silicosis and asbestosis must be strongly considered.
f THIS KIN 103 fflCHLA i 1963 ?UMT TSgMDilgD XJST \
OSOIOS W. W1KZST, M. D.
Stfat Uk*' Boopltal # 11311 ftihr Boalorairf Omia4, Ohio 44104
r n<^n u. ^.
0^
o
Nama
No. 36446
Interpretation of
single
taken on 6-29-66
^ Plant: Millington, New Jersey
Raadiag Oat* 7-27-66 roentgenogram oi cbait
A comparison of this film to that of 1964 shows no further change* Previous. comments still apply*
V*?
GXOfcQS W. WRIGHT, U. V. Salat Lake's Kaapital
11311 Skakar loilmrd
Garalaad, Okie 44104
V
\
* *> /... j /
N*m No. 27613 Interpretation of single
Plant: Beading Date
roentgenogram of cheat
Millington, N*J 6/16/64
5/12/64
A comparison of films 1953 to date shows developmer
of pleural densities sometime between 1957 and
1960, mostly on right* More m k recent there
have been minor pleural changes os the left. If
he has an asbestos exposure it is imperative that a
diagnosis of asbestosis be considered
GIORGE W. WRIGHT, M. D. Saiat Lnka'a Koapttal 11311 Shikar Boalavazd
A, Ohio
Name
No. Interpretatioii oi takas os
53 single 8/1/62
Plast:
Millington, K.J
Reading Data: 8/29/62
roentgenogram of chest
The single film shows no change frompreviaus ones of ii/lii/60 and a stereo pair of 5/10/60. There is evidence of a right side plenral reaction with some intraparenchymal change suggesting the residue of a previous pneumonia. Film of 9/2U/S9 did not show these change. Is there a history of pleurisy" or pneumonia between 195? and I960?
ts * / r * y # 4 v r/ vv>
.-rt .h-
rV
I "t 4 GEORGE W. WRIGHT, M. D. < Stint Lake'* Hotpital
11311 Sbtktx Boulevard Cleveland 4, Okie
Ice 4 sns
f
.Nab*
83-60 Interpretation of
single
taken on 4/14/60 compared with
NGC
: Millington, Kew Jersey
Reading Data : 5/2/6o
taken on
A review of films taken in 1953, 1955, 1957, and the current one shows the gradual development of what appears to be pleural adhesions at the right base. It is impossible to know whether or not there is any abnormality within the lung by looking at this single film. A stereo film and information re his medical histor of the past 3 or 4 years would be of help in evaluating this films.
dsORGZ w. WRIGHT, M. D.
Saint Luka's Heapltal 11311 Skaker Boulavaxd Cleveland 4, Ohio
o
f! orDepartment
Experimental mcoioine
tGeorge W. Wright, M. D
*.
No. Name
55-53-B----------
ST. LUKE'S HOSPITAL 11911 SHAKER SLVO. CLEVELAND A* OHIO
12-17-55
Natl. Gypsuzn Co. Millington, N. J.
Interpretation of ^^JCg^oentgenogram
of chest taken on compared with 1953 taken on
No change.
SGIkt ? .A
o
`r~~
V
0
\
George W. Wright, M.D.
Department of Experimental Medicine
SAINT LUKE'S HOSPITAL Mill SHAKER SLVD. CLEVELAND 4, OHIO
Ho. 93. . Name '
Natl. Gypsu& Co Millington, H.J,
*
Interpretation of of chest taken on coapared with
ingle roentgenogram
-9-16-53 taken on
No AbsonaHty seen*
KK '.y.bGZ
o PHYSICAL EXAMINATION
CLOCK NUMBER^
OCTOBER 1947
NAME.
A\
CITY
BLOOD TEST: NEGATIVE
EYES: / EARS -.</
NOSE:
'
THROATS ^
#
HEART: /
\
tl&pt
BLOOD PRESSURE
s'
POSITIVE
-I-*
URINE ANALYSIS
X-RAY: l/
REMARKS:.........
l
Physician's Signature
<C ' i*SG3
r.*1
.; *'
Tr vr"r*
' \ '
' - l*1 V '/T,,4 ` * ,< :?i ?-- *
Mama
Plash
in- \r n . N . J
,, ' No. 3(i41* . latarpiatatioa o(
takas oo
>-<1-
HH l
Raadisg Data roaotgasogram oi okaat
' ^sl l`
* ,p % !;'m-7B
'.viu;*u;U1y :>vmnineut; -and
irj
densities Jr, ?'oth lun'i:*, <*npr>cial!l.V^^'
Uh* t*\nhi..
i ui.r root: ar* larctbr than noiral.
y
ITiapbxa:j?r.acic jor * arc i:rc*ni^ ny l\oth Ride'i.
Theso chtitwpjs Iw.v?
opecT^radua!ly <n,t>r^ti'e~`y<VVrtf* Ctvjm"
,;-
M .in I'M*.* thorn Ij^.b berr definite tox u?mt chawtos * 'ci.ncn t;ho lfil fi3:n. The, appearance of thifl f lift' rug.T09 ts.:
a risvjfciJ <ho anNtnton in<J to nilica.' An occupational hintofy is jumiJ* c* t:r. maho a diagnooin isioro c^Uln, but
sJiiconii nn.1
tor*i>J must bo strongly conaiderod.
Gtonat w. wniQirr, u. D.
ft*lt L*k't HovpIUl
113JI
Boalarwd
CU-ralaad, Okls 44104
Naaa
No. 36440
Utaipfatatloa o(
tingle
takas oo 6-29-66
Plash Killingtoo, Mow Jortey Raadisg Data 7.37-66
foaotgaoogiam oi ebaat
w
/
A cowpori.on of thi. fil- to that of 1964 .how* no further change. previous
nmnantf . till apply*
ar.OAOl w. WWUHT, M. D.
9fal Uk`* llaaatul
lUlt Ohk Baala^atd
O...U.4 Ob.. 10 ..fcj, ...
/V
No .
27*13
lislctptrlAlton ol
single
taken on
5/12/*4
Handing Dnln
ioentg*n*9n im ol cVioal
Mui ingt on t n# J .
A/lft/M
A comparison of films 1953 to date shows development of pleural densities sometime between 1957 and 19*0, mostly on right. More ** * recent there have boen minor pleural changes on the left. If he has an asbestos exposure it is imperative that a diagnosis of asbestosis be considered
Gtoncr w. wntGHT. w. d.
t Saint Uka'i ItoapHal
' 11311 Shakat Bonlaaatd ClavaUrxl 4. Oblo
I
Name
\
Plant:
Millington, K.J.
No. Interpolation ol takes oo
53 Mngle 6/1/62
Heading Date: 6/29/62
roentgenogram ol choat
Th* single film *howe no chang* frrwproYiou" onep of li/Ui/60 and a atmo pair of 5/10/60. There in evidence of a right old* pleural reaction with Poir* intraparcncliymal change mif.^Ptinp the residue of a previous pneumonia, film of 9/?li/59 did not show them change. I* tlr*rr n history of "pleurly" or pneumonia bet^en 1957 and I960?*
GEOflGC w. WR1QHT, M. 0. Saint Luka'a Hr>*|>ll*l 11311 Sbakar BouUvatd CUvaland 4. Ok.o
o
No. 2^-57-D
j
F
Interpretation o! Single
Ukeo on 9/20/57
compared with
Ho significant afcnonaAllty soon.
Haot; JOlllngton, JUJ. {mJC)
* heading Dnto : of chest
io/V57
taken oo
t I
GEORGE W. WHIGHT. M. 0.
Sint
Henpil.t
tt3U ShUi
CU*1n<J 4, Ohio
t
N*m |
*<.
s - r* '\
TUnt :
NCC .M'lliUvtfcn, In'uw Jersey
No- 8 - - f' 0
Interpretation of
single
8<*ding D*lo :
ruootg*ogi*m oi chest
5/J/60
l.lcen on 4/14">0
compared with
tiikoo on
A review of film* taken in 1953, 1955, 1957, and the current one how* the gradual development of what appear* to be pleural adhesion* at the right bate. It ia tmpo**iblc to know whether or not there i* an/ abnormality* within the lung by looking at this ingle film. A stereo film and Information re hi* medical history of the pact.3 or 4 year* would be of help in evaluating this (Uru>.
-ri r
CEUH'.f w. WHKhlT. M 1>.
S.tii) I.iiW* Ur*pnl
It >11
Xrolmiti
Ctsvrls.H 4, Ohio
K< SGG* * .A.
. IIOISAI. t.'i 1'SI'M Ul\!!'
'm.ant. tiM iu;, sai.1 .> ih-iku r
./&*.*
vmi.'ai. kaamj.nmioa JtJ-.umn
daii. ; ii'iirMH.mMiM ! : itt i\-i uimi m i x.i'i.unnm him
o
mit'iH
_
10/27/00
__________ VlMllU'.V*
f\i.i 66 >
I.Jmm.u: KfAummn imn.ii
si kmim-imncvi'___________
.in
A I, //
in
\3
nisi ii.i iH Ml M .. i m i . ill mi >m M< k
2T'
yi f?-
I hT-ImTmN (Till > I I \7h\M`>N :if- g~TMZtC.cJL
jy^ci/
Ml (>(>l> I'll I 'I - /`SS'/fo
. ____
\ ISi tS.IMsi AM
INl'N'M Ml fltt.V'MIiMAN
CAl J~+^--
1 JyAfr.
III.IIMA
........ in'i.iunai. niM.w
M nmiAUVKM.AIts
I I MIN M > -IN
, Xt.
hil I. Ml
,i\ III MIN
.MUMMI A { I VU.I*.
JJ
t;
^rnnvi >y e -- '--r^rnffTi *>
I. 1111 I.AMD
`K \\n r; vi iif.'ff (II> -CiU'u. wri i \ i mv\ m m;i ionaj.
njTtm'JiT'u.N
*v-
. l.u K FlNIliM.; - mThuUIUmT
>s i.iimins
?U$~. <r__________ _
______________ _______________________ _______________
nw \io ui im.um \nT.n i'iu li u \ nir \m\ifs i~ \\ \\iisil-. hV'iii.KN \u\im il Tm mi.siTh \m hmhm.> >cTf>
iATlOSAL gypsum company
o`HYSJCAL EXAMINATION RECORD
PLANT, OFFICE, SALES DISTRIC
DATE S ~
67
PRE-EMPLOYMENT REINSTATEMENT [ PERIODIC HEALTH
.ADDRESS.
)ATE OF BIRTH
10/27/00
(AGE 66 )
single B^Tarried OTHER
-AST EMPLOYMENT.
EIGHT
DISFIGUREMENT - FACE. HEAD OR NECK
VISION-DISTANT VISION-NEAR
S'6"
VEIGHT
C.ILE. MgC
20/
/(,$
U.L.E. 213/Ji & 20/
HEART
\
CHEST
.
k- a*Tr>uJ.
CONFIGURATION CHEST EXPANSION
BLOOD PRESSURE
tyr/fo
LUNGS
HERNIA
INGUINALfRRIlNHGCS.s* Zf "
ft OPERATIVE SCARS
Vasserman
Hb>
URINALYSIS
sugar " ABDOMEN
Albumin rDtW.P.
BACK AND EXTREMITIES -EDEMA AMPUTATIONS, FUNCTIONAL DEFECTS, DEFORMIltTTIES
SPECIFIC FINDINGS - NEUROLOGICAL
SKIN ERUPTION *7'
SOMARY OF PERMANENT DEFECTS, IMP AIRMENTS; EXAMINEE HAS BEEN ADVISED OF SIGNIFICANT FINDINGS ^-cTT
EMOTIONAL STABILITY
y.
INTELLIGENCE
APPLICANT'S SIGNATURE JOB ASSIGNMENT
Accept Coodit. Reject Accept PREV lOUfMEDICAL
COMPANY APPROVALS
PERSONNEL MANAGER BUFFALO
|DATE
PART EXAMINED
i .. __.__ _
X-RAY REPORT - RADIOGRAPHIC FINDINGS
^^ FILM NO.
/CK^'SGS M.
.tional gypsum company
4:7 T
PLANT, OFFICE, SALES PttTmCTMtllington-PmiTQ-
^Y'SICAL EXAMINATION RECORD >E_
DATE _ PRE - EMPLOYMENT REINSTATEMENT iXj PERIODIC HEALTH
innorcc
kTT OF BIRTH 10/27/00(ACE_61>
SINGLE SERRIED OTHER
\ST FMPirmcNT National Dtp sum Company________________ _________________
JGHT
'6 "
DISFIGUREMENT - FACE. HEAD OR NECK
VISION-DISTANT VISION-NEAR VASSERMAN
Hb<
UGHT
C.R.E. 30/J^U 20/
U.L.E. 20/* 20/
:art
\
'yisC
CHE5T
YY*ue/dtt^.t+ +I.J
HERNIA
DNF1GURATION CHEST EXPANSION
urns
BLOOD PRESSURE m/jLQ.
INGUINAL SINGS
R OPERATIVE SC
V\
,ACK AND EXTREMITIES -.EDEMA. AMPUTATIONS, FUNCTIONAL DEFECTS. DEFORMITIES
URINALYSIS
-21-
'.SUGWU* . ALBUMIN
ABDOMEN / 1 L.M.P.
Y>ujl?
^
.T*L_\AOED
RELAXED
SPECIFIC FINDINGS - NEUROLOGICAL
SKIN ERUPTION
SLAW ARY OF PERMANENT DEFECTS, IMPAIRMENTS: EXAMINEE HAS BEEN ADVISED OF SIGNIFICANT FINDINGS yhu^UUjU
so
EMOTIONAL STABILITY
IWELUdENW " uZm """"
_____ ___________________
/
APPLICANT'S SIGNATURE
w
Accept Ccadu. Reject PHYS)ClAN*S^KiNATURE
AS J
Aecept
______ _______________________________________
JO'S ASSIGNMENT
PREVIOUS MEDICAL
COMPANY APPROVALS
PERSONNEL MANAGER BUFFALO
[DATE
PART EXAMINED
X-RAY RpORT - RADIOGRAPHIC FINDINGS
FILM NO.
.tJCT .ES
MANAGER
PLANT MANAGER
yr s.
a
Kk '.i'-soD
SAFETY
M.
NATIONAL GYPSUM COMPANY
'*
: >'; .
'
Sales District Office
ie Date Afe-te
Color
Arthritis Operations ... Venereal Diseases
^
Dcpt
Address
---?l*?` nvunstaa.x.j, -deck No. 44
M D*
Children
PHYSICAL RECORD
(TO BE COMPLETED BY PLANT OB OFFICE)
Epilepsy
Hernia -
_____
List M xovasa iU* aar baapital
.......... ... adaiaaioaa ia past S yarn.
Tnhercolosis
Liqoor Other Illnesses
*
Tobacco
Drngs
. ... ------- ---------------------------
...
tniories -- description, locat on, % disability Compensation Received
Hava foa a hialAfy af aUicaaia at aar othar dut diaaaaa?
Do f*i hara a awksii1* eoapasaaiioa caaa paadlaf far aitba iajvr or Ulaaaa?
Hava raa mr baaa la ailltarr aaroiea?
t
Hare aar of rest pwaata or brothel Tubercaiotia, Caeca, Diabatea, Epilapty or Inaaaitr?
Last previous employment j
I-cartifr .that tht abo*a tu*^ art trua, cocractir racadtd, aed that I aaia toad baalth. aad that 1 Eaoa aava aaHartd fraaSgjcoais, atcapt faatarrT
Signature of Applicant
Witaass
* divorced, give date and plaee
Height *5* *C Eyes: Rifci
PHYSICAL EXAMINATION
(TO BE COMPLETED BY DOCTOR)
eight
vz.
Lafl
/C*/.................... ..... Corrected: Rifct
Pnpjls
Cornea j/
Langs ^
Shortness of Breath
Heart
Blood Pressore h
Ova* Vaifte Naraiai Vaifht ' Oada Waiffci
Lett
Biascal ax Viaiaa
Chest X-Ray
Poise -JZ-
Ears
Throat and Tonails j?
Abdomen
Spine
y
Extremities ^
Nose ^ Hearing: Right ^y *C
Hernia Hemorrhoids ^
Teeth
^7ve
Sci SRkeinflexes ^
Blood Test V
(Not* % ai dadaea tf cay exist)
(Haad aad sack aaly -
Glands.
lacabea)
Mentality i?
Urinalysis 0f
Moscnlatarc {/ Genital^/
General Condition: Good U- Fair *)o yoo recoaaead applicant for work?
Poor
Tforition; Good F Type of Work?
~Fa
Remarks
Poor
APPROVED
FOREMAN ' '
SAFETY SUPERVISOR
---------------------------------------------------------- fjjf-jt
Examined by
//
---------------------------y j
/^
- /.nwnmnN tc ntnvw by me enpenvrenn YES TO. NO
. ,;r
NATIONAL GYPSUH COMPANY
Sales District
= ,, Office.
Addfeirb..- Pi*at Millington,S.J,
Date '
/d Age 60 .
Color
Arthritic Operations Venereal Diseases Liqoor Other Illnesses
Dept. ' ' ......... .......................... ' Check No.~~76 ~
C
S M W D* .
Children
PHYSICAL RECORD
CTO BE COMPLETED BY PERSONNEL DEPARTMENT)
_ -.1.........................
Epilepsy
Benia -
- -**-- -------
List aa tavaraa aid# aay bayitil
a^lartuaa tayant $ yaa,
--
Tuberculosis
Tobacco
Drags
.... ...-------- --------------------------------- ------ --
...
Injuries -- description, location, % disability
Compenaadoo Received Banayr*atrtatir adaUitmdkitaaa(aift_li_c_M__ii_n_
D* yn Wt ntkMi'i eo^MMiiea cam adk far aithm iafrrr ar ilisasat__________
Hava yas rrw fcaaa te gjfty aaariea?
Bar* aay of yaw ymati ar kietktn or siawra bad Tabarealaaia, Cancer, Diabataa, Epilapay w Inaanity?
Laat previooa employment_____________________________________________________________
1 cartify that tka akor* aaaarara ar* traa, eecraetly raeotdvd, aad tkat I aa la_ tood baaltb. pad that 1 harr a*rr aoffarad hea SHicoaia. aacaal ftiiltay)
..
Signatarc of Applicant____________________________________. Witaeaa ________ _____
' divorced, give date aad place
Height
Eyes: Bi|k
Pupils
.
0
'L
Laft
PHYSICAL EXAMINATION (TO BE COMPLETED BY DOCTOR) Weight /r^T* ..................
Corrected: lik ...................
Cornea 4/
OrarVafck NMifd|k Qadar Vaigk
___________
Bia*calar Vkks
Longa Heart
Shortness of Breath \s
Chest X-Ray
Blood Pressure ^^2 *------------- ......... ...... Poise 7 7,
Ears U Throat and Tonsils Abdomen
l
Nose ** Hearing: Right
. Hernia " ^ "
Teeth ^ Left "^/U
^
---------- --- ------
Spine
1/
Hemorrhoids p ------------
Extremities ^ Scars Is Sirin U Reflexes ^ Blood Test V
(Nata % ad dafoca U aay wdat)
Mnscnlstnre *
(Baad aad sack aaly - fir* lacattaa)____ Glaads l/
Genitals
Mentality
...
Urinalysis L>
-
-
General Condition: Good
Fair
Pom
Nontion: Good t
Far
Poor
jo yon recommend applicant lor wort.7 rf
lypeotwcoty^
1
1
j
'5
' 4> 0^
M
Rendu
APPROVED
FOREMAN -Safety
SUPE*--RV* ISOR
Er^iaadhy '
- ;-
/a a*. y - / ?.
tfa&t
1WW
1" l
/
Name
lie
_Aee
Wll IT- lfft Color V
Arthritia "L. -Operation* -- -........ - .......Venereal Diseases
N A T10N Al JGYPSt}5P tO VPXNY
....."...........a...*..w..r..'y*jm an >*- i~to iiia^rn
'
Sles District _mmm Office
Address*
: . Plant jftlg
Dept,
1" S . ,mLw_D*
Check Ko. Children
PHYSICAL RECORD
.. CTO BE COMPLETED BY PERSONSEL.DEPARTMENT) .... T______
Epilepsy
:. Hernia.
List ea tevarae aida aay hoeyttal
-
Tnhercnloeis
Liqnor
Tobacco
Drags
Other Illnesses
lajarie* -- description, location, % disability Compensation Received
Have you a hiatory ef eUieeaia or aay other daat diaeaae?
Oe yaa have a taiatt't cesoeatatiee eaae yeadiag far aithar iajary av lUaaaaf
Save yea ever bees U adlitary eervicef
*-
Bat* ur oi yow ptuau or brother* or liitin had Tufeercaloaia. Caacer, Piaheue, Epllepay or faaaaitf?
Last previous employment
1 certify that the above laawera ere true, correctly recorded, eed tbet 1 e is _____ _____ ____ _____ good health, ead that I have aeeer aaffered froa Silicoeia, except (hiatory)
_ . Signatnre of Applicant
_ Witness
* If divorced, give date and place
Height
j6l
PHYSICAL EXAMINATION (TO BE COMPLETED BY DOCTOR)
;/2yt
Eyes: Bight
Loft
Corrected: Bight
Pupils___________ ms/f
Cornea
Longs
Shortness of Breath
Heart Ears
7
Blood Pre Noae'
Throat and Tonsils
Hearing: Right
Over Weight Kasai Weight "Videv Weight "
Left
Biaaeaiar Tiaiaa
Cheat XRay
Teeth /
Abdomen
-- Spine
j_
Hernia Heaorrhoids /f-------
Extremities tears Sldn -- Reflexes
Clanda
Qttu % ot dafecta if asy axial)
Mnscniatore
(Bead aad seek eelj.-jtte iecadaa)_______
`Genitals
------ Mentality IZZTZ
Blood Test
Urinalysis
General Condition: Good
Fair
Poof
Natrition^ Good
Fan
Bo yon recommend applicant for work? 4Reasks
Type of Workf
let-d-U*t-K7Z
APPROVED
PORQAAN --SAFETY
SUPERVISOR PLANT
MANAGER
p~ v'^/7 ~ sy
Ewxeaamwicneead abyy ^ , ,tf----W " *---- ----- ---------------- U------------- --7-----------------
THIS EMPLOYEES CONDITION IS KNOWN BY HIS SUPERVISOR. YB
NO
-.^S73
/
IjXCK IT3TSB3B ' :-:ae
ADDRESS . <. CITY
' p-risiiur. exactiticx -:
7$ '"
DATE. *.
feat **1951 ' '
. ?.
\
V w
5LOOD TEST
EYES
/
il/id
v`X f /^-oTX'
EARS
L
>
ffOSE
v_;___ .
C7"
. THROAT;
</
HEART
'- .BE007. FEES SURE
.' 4 - .3'-
*
EEINE ANALYSIS
V
N r.
'
-V
l
\
--
vxX ,
*
42 ' / 74'
, ; ' - t -
'' - 4 . OA-fM*.*- i--' vW 1\
^ '' *
X-RAY
X Us .
. REMARKS ""
:. A*
..
' V"'RX
,-3
Physician1* Sl^oatve , , .' . '-. - .*. a
* .t *
h-
OA
# iTh^i.t- l. '^lsckVjmssr
r i*:.uy,* *. 'y*
*
"1*V"
y-'*' - SAKE
7'/ ' * = ADDRESS
!'. voixy
' ;-
76
5LOOD TEST
.
EYES
/_
U . EARS------1?-------
KOSE
<7
THROAT:
li/i'
7
. /.miration
DATE
-*
j*
i
.- ^X
*'* iMo
_ 1
{\
HEART RLCC7 PRESSURE
/ / i * -/
t-RINE ANALYSIS X-RAY . REMARKS
----------------- \r
, .. Jon* 8,1951 : ' :
\ . .. V . v. * * , \
, - '* /* , V \ \
v
% ,
**>
Hnvjir.iwt1 o
/
*< 7v^..
parsnui
> ' :
*.rj..' .
o %CLOCK NUMBER
HMZ_ ADDRESS
'V' C-
/ .* -
f-
DATE
FA
cirr 4. STATE
* *
5
*
//- xt- /z
t. .
'
.
;-7k -
V.'
<V *V i V' . \*
. *. ' j
zmi-
BLOOD TEST
BTES
EARS
NOSE
*: /TIIBDAT T7
,. HEART BACK' ^
twjrf BLOOD; PRESSURE '
IS HERNIA
_ ^o-* i*-o '* < .
\''X:
v-"^: tt-i
..... <*.
. ' ;r * >>v -few V
- . v. ' \.\ .r
- m -- ,
! .
! .*{.- **;.
>
4* ''* i * pi*
7* >a '
*v
> V-V:; '.; V. . . ........... ..
. ! "1 . V-
> ?A-V
.. .-
Jti..;- t-'Zi
URINB ANALYSIS^ X-RAT '
22
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:P7I054 INJURIES
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Nittnr
O Date April 17, VJ59 --ss-.......... Color
Arthritis Operations ^ VcnerenJ Diseases
Liquor
i
Other Illnesses
NATIONAL GYPSUM COMPANY
iiismc: Office___
Address
Pinm
Check No.
SM
IP
Children
PHYSICAL IU-COHI)
(TO m: COMPLETE!) UY PERSONNEL DEPAinmNT)
Epilepsy
Herniu
{.a* nn taaa.aa a>dr any koapila)
tdmitiiM in paal S ***>
"
Tuberculosis
Tobacco
Drugs
Injuries^-- description, location, % disability
Compensation Hereived
Ilaa* yn hiamrr nf atliraaia nr nr whf dual diaraar*
_
Do ? ha** Minra't r*n*rMliM caaa f>*ndinj far ritku injury nr tllarn*
in niliuo imin)
Hava any nf rnur parania nr hrnthara l atalrra Had Tul.rrrwlnaia, Cam rr, Oiabrirn, Kpilapar #r Inaanity '
Lnst previous employment
1 rrtutr iKal |K ahn* immii at* liur, ranrrllr
an.I that t am in
|od haallh, and lhal 1 ha* n***r awtt*r*d from SUicnaia, ufil (hiatory)
Signature of Applicant
Witness
If divorced, give date uml place
.ghl
Eye*-
/ /
l.eft
PHYSICAL EXAMINATION
(TO K COMPLETED HY DOCTOR)
Weight -
r
Corrected: Hi|iu
Pupils Lungs llenrt
Comes
Shortness of Hrenili
Mood Pressure /
/
Ears
Nose
y
I lirout and Tonsils
Hearing: Might "
.t
(>**r (ti|hi Normal lri|lil Undrr T*i|h
l.eh _
flinai gla. V.aiaa
Chest X*Mny
~=t7
Pulse
Teeth Left ")f
Abdomen Spine
Extremities
Scars Skin
II r f| r \es
lr-(
s' ^
*
.
Herniu
*s
Hemorrhoids /
\ nl ilrUrit <1 any mat)
(ll-a.I ami n. k nnl* . . ImalM.nl
(ilhinl`1 Mentality fS
LliitaLsiM
M*vulutuye (ieuiluls
(eneril Condition: C...d Ho you rrfuninietid upplirnnl lor work? ^ j
jVi
P.Mir
Nutrition: (md Type of Work?
Feir___
Poor
ICX ^S77-
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OH KM \N
NAKEtl
SPPLII t INOH
PLAN I M i N \/; | i|
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E rnrnined |v
J
mis mim m M.*s roNornoN is enon hy ids sppEimsou. y>* (I^-no 1 !
Name
o Di.tr 6Q
^
Color
Arthritis Operations " Venrre.il Diseases
NATIONAL GYPSUM COMPANY
Solos District
Office
Drpl.
AddiTt*-^
^ I'Unt M4 llington , R. J .
Cheek No. 76
S M w !)
Children
physical m";C()iu)
.......... .
rro m: comih-kth) my pkilsonnki. dlpahtmknn
Cpilepsy
Ilemiu
t.jal ot f***f #4 OAT kotfllli'
tniMiono i* paat $ j*ra,
--
Tuherrtilosi*
Liquor
Tobacco
Drugs
Other Illnesses
Injuries--^description, locution, % disability
Compensation Deceived
It V fog Hialorr l liliftfit o' at e<Kcr dual diaoaac?
_
Pa fi* kao (MtA**'* rornffOAiiiui r* ipt Ailtiff i|n Af illiout
tl ia atilitarf Airf>
ii* anr a* four paroata ar braikora f a.aiara had Tubarruleaia. Cut*r, Oiikftra, tfilrff? ar iaaanitf *
Lnst previous employment
l ro.tift ikal iko ikotr aaora at* Ini', ronorljf tooi.nio.l, *aI that I am ia goo.t koaltk, ao't itial I tia o aulio.o.l ftas Sitiopa.a, opt (kitintf)
Signature of Applicant
Witness
If divorced, give dtuc nnd plnce
K*'t _______ '&
Lyes: Ht*M
Pupil j/
Lungs
lieiirt Lurs
U
Throat nd Tonsils
*
,,e**
PHYSICAL KXAMINATION (TO HKCOMfl.KTKI) UY IIOCTOIO
height / 7J"
Corrected: H*gM Comes C/
Shortness of Hrrntli L* lllood Pressure
Nose
^
llesring: Might
^/1*?
t)*Af Ot|kl tlArwal Voight IIAtiot Vflfkl
1-0*1
ItiaM wiar
V.a.aa
Chest Xllay
puUe y *2,
Teeth
^ **%>/. *
Abdomen
Ilemiu
u
Sfiiue
^ ________
ll.emorrhoids i,
f'.tlremitie*
Sears
Is
^
Skin
is
Mlflt-MH i/
<Naio % a< .lotarla it as? **atl
(.lands
|II*J nit bo. k aaif .. gif a |a< iimal
.\ieutnlilx
^
Miititiiltitufe ** (.emtuls
lllood l est ^
Urinalysis
Cencral Condition: Cood ^
r Nutrition: Cood U Loir
Do you recommend opplicnnt for work?
Type of Work ? I
" /ks
Poor
... I'HOVU)
KOIIkMAN SAKKT ^ sum in ISOil
I't tNI
htiimined liv
Tnr
JW!
M.P
NATIONAL CYPSUM COMPANY
Solos District
oNome
:'jS_fe2_
Color
Arthritis
--
Opernlion*
Venereal l)i*eiN*_
1 .iquor
Dept.
4
Addre*
l rut nillington,N.Ja Oink N<>.
M IP
Children
PHYSICAL HKCOIH)
(TO |IK CllMPCKIKl) MY I'l.ANT nit <>mCK)
Epilepsy
llrrnin
l.iai f>m #* wl *nr h"|tii() *Hniiitaa yaai S i.ua,
Tuberculosi"
Tohnrco
Other Ulnesne*
lnjune -- description, locution, % disability
Co)i>lro<*ntion lleceived
){a.. tv hialorr of ailieoaia ot rif ei^rt Huai diaaaaa?
Oft *<tti ktt. aMtati'f < >'iap.auiin i . Vdi| t> eoba. in> .. ilUaa.f
tilitarv oif'
lUr. r of fnvf t araftta Of bfolhafs <*f aialaia bad luk.rr ulfifii, Ciuirfi, Oiafcalaa, Kfitf|f Of Ifiaomly *
Lust previous employment | f.riilt that ik> ahaa **.* ara map, ritrrartly r*ffa|<(, *) lkl I am in
food kaalih, and that | ha na*t awff*rd from .Siliroata, rifppi (ktaiorr)
Signature of Appliennt
Uitnem*
If divorced, give dnte nnd ptnee
Height S- C VLyes: NiM _ /^V
PHYSICAL EXAMINATION (TO MK (iOMPl.KTKl) HY IKICTOil)
height 7jy l.afl
/ */
Corrected: HtfM
Pupil*
(i<imen
Lung* Jlrnrt
/ y
Shortness <>f Hreoth'>ft^ry^ Mood Pressure <yy/f2-
Car* ^
Near ^
1 linmt and Tonsil* y .
llenring: Highl
+o
A Inl.mien s
llcrnin
g
Spine
f. L/
r.tri*HiatieN w
Sn.rM
V*
"'tin
^
llrflfw^ ^
Cloud** ^
Hemorrhoid* ^
i| f !()
{ e fc **!% |t io (*) Mrnliltill jS
Mint'd I fiat V
( IrilMlI) MIM t>
(.etiernI Cnnditinn: (U
1' nir
nt recommend npplicnnl for work? /L
cmurk *
I'ltor
Nutrition: (mhI Type of Kort?
itf.i
K"M(I *i f ht llradat i*t*k
l .mil
iiiftarui r
V !>
Chest \Hy
Pulse
Teeth ^
Left
Mnecnliiinre ^ CeiiiKil-X^
... I
AminVkl)
H>UK\MN
mh:iy
supi.iivistm
I
!
!
|I'.tm
Dole
;intir - >r-Vi m nMns^
f' I'J.AM , 01 1 iu:. >\U.> lib 1 UM I Ui.ll;ugr.rJiC.ur.
SC.U. i:\AMl V\ ( MIN Ifl.l (HIM .
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U1HI*
M\11, l!l INMUIMIM X n wmm in Mill
i.oi iuiuii_1/22/.Q.O__________ <m.i J>.
. -mm.u: f*><r\Kim h oimu..
rKMINational G-jpaum Company;_____________________________________
MI //
nr
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j'-tmii >lr-
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"* \Mimmr.imii''nf. 1 I .11.1 .
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ii.i'll \ rins ru^'* i'T\1'\vmmC
miThiii im "i-iy*'"*
ItNc.t iN\7"iiis.'
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KSjUlU^_____ ______________ 1
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IONAL * > Pii >1 unn * 51CAI. EXAMINATION ItKCimi)
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67
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W niKTU 10/27/00
f Mil _66_>
UHIHKSS
stMiU-;
nn;K
r KMi'unMvvr______________;___________________________________
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vimon.imma\t
c.h.k. vtgo nj-K. a/jt
UNION. MAH jUANNUISUN
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JO/ ItMNAl.XSK
5*>/ ftSI-CAH 1_ fyf 1 MI AON
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flKHNIA _
>7 S f\- A* s9Kma*u** jyxjJ a.t> ' f+p. * <4. -
FIM'BATION CIIKST KX*ANMON jJ.
i/ >
Ml.*H*l> I'HKNNl lit I'Sr/fo
mumsAi. iunun*' ,,
II
Ol'KRA VIYF. SCARS
e \.
AtttMHtt.N |l
JU * . ilHuJ -- N muiwn ^ HM.AXU)
________________________________________ _ l.K AM) KXTHI Aimr.S -KlttMA. AMP(TA I'IO.Vj, FUNCTIONAl. DKKtCTS, DtKOWMlTlt-S
' .1. UMI|Vi> - NmtOUX.JC u.
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( VM MiV (II I'l.HVIAM.M lll.n.l.r.s IMP \IIIMIY]'; I.WMIM.h HA> Ilkl.N MIWM.II (II Ml.MHl.WI
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motional s rAi<u.m
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Arn.JI.AM -N Ml.N \ 1 I'llK
A. i j-i i< .unAti. H.j.rt ........
ion annic.vmlm
IMlKVKM <MM>II.AL
LUMLAM AIM'IH )VAt > I'MIVINNU
III V> Al.O
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TtlU K.XAMINKJ) -----------------------------------------------
Y U.M so.
^cTf"' D'd
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T1UNAL TM PSl M L OM !' A
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PLANT, 01 I ILK,
Ob ntinKilllngtgj&l&ur.
iSICAL EXAMINATION RKLOIUI
o
I>ATK,, 1 "'pm-iMrumiKM f :m:iN<ruiAsr ? intuodm id M.m
.1:01 imnn io/27/qo<u.i 65 i
; jsisu.i: J^rMmnn ouir.u
T KMPLOIMIVT National Gypsum Company
___
;n r DIM'-Hit HKMKM - l` \< t . ID.XD Oil M-.i k
VlMoN-UIM AM \ ISJON- M- All U AkUM\N
Id :
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no
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y>y^u.c,U^t^ f.1 X.*
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ni.oon I'lii.sM-iy
lar^uL &<y*U<Mu_ _ t5//j_r>
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ID.DMA <y
211/
Af.lCfMIN A HIM IMK S /f | I..M.I'.
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V-
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tAMTC I 1NDIV.> - M.l KUUM.U \L
J.N EKd'HON
AM Ain 01 PERMANENT DM I .U S. IMP AIRMEN I v. EXAMINEE II.AS REKN ADSIM .D M Ml.NIIK. AN l HNMM.>
d
J&L^C
tC*-^
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M* .
iONATIONAL GYPSUM COMPA
Sties District
Office
DpP
Name:
A8* ^2
Color
Arthritis -- Operation* Venereal Disease*
Dept.
Address
.. p.`"l_ WHI lngtoa.H.J.
76Lheck No.
M D
Children
PHYSICAL RECORD
(TO BE COMPLETED BY PLANT OR OFFICE)
Epilepsy
_
Hernia
Lot oa
odc ony heopitol
tOutiiMi it put S )<.
Tuberculoaii
Liquor
Tobt
Drug*
Other Illnesses
Injuries - description, location, % disability
Compensation Received Hove you hi*toIT of ilieooio or ny other dual diocooo?
0* tom ItoTT o MMkMi'i rwyuuiii COOT yiUii| lot TitWct imjury 0* illoooo?
Koto you ovor btta io oiilitofy oomee*
Hot* ooy of your poroeto or brothero or oiotoro hod TubercuJooio, Cooccr, Oiobotoo. Epilcpof or laoooity
^^_
Last previous employment
___________
2 certify that tbo obo* oftovero oro true. eofroctly recorded, nd (hot I on to
ood btolthj oed tbo( I ho** ee*r coffered from Silicotic, except (hiotory) a> __ ...
Signature of Applicant
Witness
* If divorced, give date end place
Height Lyes: flight Pupils
PHYSICAL EXAMINATION
(TO BE COMPLETED BY DOCTOR)
^ ''_______ _______ S.&yL
V </a7 ^
Loft 2_
Corrected: Right
_________________________
Cornea ^
Lungs___
Shortness of Breath
Heart
Ulood Pressure
Ears
^
None ^
r
Throat and Tonsils
Hearing; Right
O*** Weight
Nexwel Weight Uador V*i|M
Loft
BiaecuJor Vioioo
Chest X-Ray
Pulse ~IZ-
Teeth ^
Left
VQ
Abdomen t/
Hernia
w
Spine Extremities ^
Scorn
tf
Slun
Reflexes
11 loo*1 lest `V
Hemorrhoids y
(Net* % of dofoeto if ooy ottot) Oleed ood aech oaly _ gieo loceoea) Glands
Mentality Urinalysis p
Musculature Genital^
General Condition; Good -U- J-'air > you recommend applicant for work? At.
Remarks
Poor
Nutrition: Good Type of Work?
Fair
Poor
kk '.;:ss3
APPROVED
FORfcXAN
SAFETY SUPERVISOR PLANT
Date i
Examined by
5c.Tills VAtPt twvrS CONniTtON IS hNOWN BY HIS SUPERVISOR. YiS
*0 r
bg i ATIONAL GYPSUM COMPaLJ
uur-
Sales District
Office
Name
JUdijbi- --
Age toQ ___ _____
Arthritis
--
Operation* ______________
Venereal Diseaaes
Address
_ _ _ _ Plant M4 JLling'ton, K J.
Dept.
_____________ _ Check No. 76
M W D*
Children
PHYSICAL RECORD
<TO BE COMPLETED BY PERSONNEL DEPARTMENT)
Epilepsy______________________________________
Hernia
List Ktmt tide *<rv kM^iuL iisiifjM it pt }
Tuberculosis
Liquor____________________________________________ Tobacco________________ j___________________ Drug"
Other Illnesses
Injuries -- description, location, % disability
._
,
Compensation Received
H* rou hittsfr of iiliCiit* r r ache* dmt
_____ ________
O* T k ttkMt'i _________ I** *iikr isiurr m illin*?
CM*
Httt y--
imi*T itmcc?
Ht* tar i four pwtou or ktibtft or tioicrs hid
TgbtrcuJotit, Citce, Ditbrtri, EpiUpiy or Isoosicy?
Last previous employment
__
_
1 certify (hit ikr tktrr ooovoro or* true. Ctnrellr recorded, tod (hot I is (ood bcijih, tod thot^l ktn ooeor uU**td fro* Silicooio. iictpt (hiotery)__
Signature 0/ Applicant
Witness
)
If divorced, give date and place
Height Eyes: Riabt
Pupils
Lungs
S'i"'
^Ao 7
Loft
PHYSICAL EXAMINATION (TO BE COMPLETED BY DOCTOR) Weight / tjT
Corrected: ftiafct
Cornea Ls Shortness of Breath L
Heart Ears
(/
Throat and Tonsils
*
Blood Pressure
Nose
^
Hearing: Right
/Jd'
Ovor lri|ki Nwoil Vi|hi Ifodor *<<
Lift
BiMtvlir Viiiia
Chest X-Ray Pulse 7*
Teeth t* Left
.
Abdomen
**''
Hernia
w
Spine
V
Extremities ^
Scars
u
Skin
i/
Reflexes ^
Hemorrhoids
(Not* % of dolocto il ir onol) (llrod od oork oolr -- (i*o locoaoo) Glands \s _____________ _________ Mentality \__
.
Musculature * Genitals ^
Blood Test . ^________
Urinalysis L-
General Condition: Good
Fair
Poor
Nutrition: Good L
Fair
Poor
you recommend applicant for work? lemarks
Type of Work? 1
APPROVED
FOREMAN SAFETY SUPERVISOR PLANT
/) . /a
Dot. ^ - / f- O /
Examined br
V
'
THIS F.MPI OYKK*S CONDITION IS KN01N BY HIS SUPERVISOR. YES | ! NO
M 1
o
LIX# i?S?_ Color yf
acases
Rational gypsum compa)
Sales DistrieV'^ Office
Address
Plant MU,
Dept.
uneck No.
M W D`
Children
PHYSICAL RECORD
(TO BE COMPLETED BY PERSONNEL DEPARTMENT)
Epilepsy
Hernia
List revsras aids r hospital
dsiiiM is
S rests.
Toberculoaia
.......v.... i i
Tobacco
Drag*
eaea
description, location, % disability
.lion Received history of silicosis at uat diseast?
pi row paresis or brother* ot sistera had sis. CaAcer, Diabetes, Epilepsy or tesaaity?
D you k*fi I
msmitltl cu
yaadiat it alike* isjury t Uloeae?
Root yas aver beat is ttUarr sanies?
-
rvious employment
that the sb*c snowere art true, correctly recorded. sad that 1 a* is ith, ead that! have sever suffered frost Silicosis, escape (history)
ire t yplteant
Witness
t
give date and place
u <: R<H(
Lett
PHYSICAL EXAMINATION
(TO BE COMPLETED BY DOCTOR)
Weight
-/ --
Corrected: Ri*Jt
Ovet lit^ Norwat Vajfbt Usdsr Waifbt
Left
BiOOCtlitr V.oios
iis Cornea
art /
Shonnea* of Breath Blood Pressure ^
Nose
f /
Cheat XRay
Pulse yz---------------------------
Teeth --
.iroat and Tonsils
^
Hearing: Right ^Ss
Left
bdomen -pine
^
Hernia Hemorrhoids /
Extremities Scars Skin Reflexes
H|r--| Te**t
^
-/
*
{Not* % of tfMU if asy riai)
(H*f itf sack nIy |ivi Glands
S'
MoacaUture
s' Genttali
Men tality___^_____________
Urinaiyaie__ ^'
cf*l Condition: Good
/ Fair
uo you recommend applicant for work? y J
Remarks
Poor
Nutrition: Good ..
Type of Worit?
Fair
Poor
APPROVED
PORFMAN
*** w:E*S CONOfTtDN IS KNOWN BY HIS SUPERVISOR. YES >"'*0 O
o
UMJ.IJU.*
jim iipwjr
,y Mamo*
No. 36 446
laterproUttoa of
single
SK ; Uboa oa 9-4-68
Jf
Tbat'\- Millington, H.J.
iltHfaj Dote foontgoaognm of abort
10-1-68
The bronchovascul&r markings are unusually prominent and are irregular, nodular densities in both lungs, especialliy^orV the right* The lung roots are larger than normal* Diaphragmatic adhesions are present on both sides.* These changes have dovelopea gradually overtne yeais~from "normal" in 1953 r.t^ere has been ..definite further changes 'since the last'fam^VThif^ippe^aai^.'film'^siiggests a mixed exposure to asbestos and-to silica. vAn occupational history is needed to make, a diagnosis more .^certain, bet silicosis and asbestosis gust b$ Strongly considered. ..
W1XOHT, u. n ^ A ^ la.tSA lakiI'i HoipHil
Boolmad
44104 '
KK ".i V?6
Name
>
No. 36446
Interpretation oi
single
taken on 6-29--66
Plant: Millington, New Jersey Reading Data 7-27-66
roantgenogram el cheat
A coaparitoa of this fils to that of 1964 shoos bo farther change* Provisos sonants still apply*
GSOBGK W. WEIGHT, U. D.
Saint lake'* Hoapital 11311 Shake* loalmti Oeeelead. Okie 44104
.a
Nam*
No. 27613
Interpretation oi single
taken os
5/12/64
|
f P1"fc / Millington, N.J. "* at* 6/16/64
roentgenogram oi chest
A conparison of fflna 1953 to date shoos developner
of pleural densities sometime between 1957 and
1960, mostly on right. Mors m s recent there
have been minor pleural changes on the left. If
he has an asbestos closure it is Imperative that a diagnosis of asbestosis be considered
GEORGE W. WRIGHT, M. D. Saiat Lake's Hospital 11311 Shakes Boulevard CloTalaad 4, Ohio
kr
I
o
< i
\
Naim* No. Interpretation of taken on
53 ingle
Plant:
Millington, M.J.
Reading Date: 8/29/62
roentgenogram of chest
8/V
The tingle film Aon bo change freopreTlooe coet of li/Ui/60 and a ttereo pair of 5/10/60. There la evidence of a right aide plevral reaction with tone intrapareDCfaymal change anggeetlng the rettdne of a prtrloat pnenaonla. 711b of 9fib/$9 did not Aov theoe chafe. 2* there a hitter? ef plenriey* or pnranonia betones 1757 and 17607
GXORGX W. WRIGHT, M. D. Salat Lake's Kmplttl 11311 Shaker Boulevard Cleveland 4, Ohio
ICK * *
\J
Name
No. $3-60 Interpretation oi
single
taken on 4/14/60 compared with
HOC - -
Plant:
Millington, New Jeraey
Reading Data : roentgenogram oi ehoat
5/2/60
taken on
A review of films taken in 1953, 1955, 1957, end the current one show# the gradual development of what appears to he pleural adhesions at the right base. It is impossible to lmow whether or not there is any abnormality within the hag by looking at this single film. A stereo film and information re his medical history of the past 3 or 4 years would be of help in evaluating this films.
GSORGZ W. WRIGHT, U. D. Saint Lnks's Hospital 1X311 Shaksx BooIstwcI Clovslaad 4, Ohio
Nam.:
* S'
Plut: WlHifim,
No. J8-57-B
Hooding Data:
Istorpratatioa oiv .jlaglsnr
roantgattogtMa of chart
taka&oa J/M/S7
compared with
takaa o&
S df^unt hnr>m111|r
- (m)
G10BGZ W. WRIGHT, M. D. Sai&t Lake** Hospital 11311 Shaker Booierardi CleveUmd 4, Ohio
> A.
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