Document omGJB5mXvoroKaj56Dk4zQxDw

>Mf,`iil>4',,hff','MJ/\'SVtIM<* V--t M r i' f l , v j : i \ " < 1 5. i > ?-. > ` i -4. if1;1, .,../....,w <.,A:,,,`;f'v4..` AX-i' JJ.1V* u\* /* v j'''w>.'v Tl---- < u iSf ..UM S.,<'>/** l , '* * ` V ) \ ^ ', ' S ' X ' "Norwood" BRAND * ^ *'t< p| X ' <'/; / t ' ' V1 V .>' `p, f/s, < *i *i * u > ' F' FX1v. * , .* ' j t t ', tp A'- l (v'*. i ' t % ' ?*`' " il 'C , ,.,w ' f,''1v 't V*`'* ' \i S<4,?f<C'rJAl <'i, vV MMM. TO DUPLICATE THIS FOLDER ORDER Slobe-^V&rtiiclcc NO. 91-1/3 MADEINU.S.A. l /; m l Miu`m u` -p-f.{i frJif x- V* J X X r X X `; tv^H X" r' *i:a^ f >% 4U XF y'*A-f <>i t,4Vi1^ ^ v . . - ........ . ' . * ..-. ^, * * U? , L ' 1 % - $)t%%<**.>'/ ` t M/t <* r S*i*i <\ ' w' i( V ' .!' .1 i ..v ;-.: /{ \ r , v j i -' ., T ' : ' " `^ v . , ;- . A -- ' V V ; . 4 .'\'.V:-v ,: ` Iy /i M ^ , . V! ' *'/- v;i"`-'' ** / Tt >f m ON li 0016537 \yLa .-'' X Dr. R. A. Kehoe University of Cincinnati College of Medicine Cincinnati, Ohio 3-15-40 Claim N o ....0D..12.3S2._______ __ NAME. ADDRESS.. 411..I&UT.ftl--$.t*. .TX.%ai.ejpt,,Bureau Dear Doctor:-- Cincinnati, Ohio We are referring the above claimant to y ou f or...e^mimt.i.sn..&...4 i5 osis to.d.etmi.ne.the .degr.ee..of..disability npw..presentA..if..anyA..Ufi..P...SC.aupAt.ii>nal di&aaft..euid.Ady.is...M...t.o..trsa.ti5nt*..... ....................................................... ................ You may notify the claimant at the address .given above when to appear at your office for this purpose. We are enclosing, herewith...f.utj.re..fiis._fox..review......... ... ........ Kf 0016538 which will give you a history of the case, as shown by our files. Kindly send your report in TRIPLICATE, together with your fee bill, direct to the Medical Section, as soon as possible. The extra form enclosed is for your files. In preparing your report, please use the following subheadings in the order given:-- (1.) HISTORY-- of injury and treatment, past medical history, pre vious injuries, family history (if applicable). (2.) PATIENTS COMPLAINTS-- describe in detail even if they have no apparent connection with the injury. (3.) EXAMINATION-- include all objective findings, clinical, lab oratory and X-ray. (4.) DISCUSSION--- summary and treatment indicated. (5.) OPINION-- extent of disability (total or partial). If total how soon will'he be able to work. If partial, estimate degree on percentage basis if possible. Use the Form (C-lll) enclosed and continue your report on the re verse if necessary. SMHimpr Very truly yours, DR. SIDNEY MeCURDY, Supervisor of Medical Section. IN R E P L Y IN G , A LW A Y S G IV E CLAIM NUM BER. NOTIFY T H E C H IE F IF YOUR IN Q U IRIES ARE NOT ANSW ERED W ITH IN TEN DAYS.