CONSULTATION SHEET - CARANCI, JOHN C.

• Document Type: FOIA
• Keywords: PERSONNEL FILE
• Keywords: CARANCI JOHN C
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001415066
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 1
• Document Creation Date: June 22, 2015
• Document Release Date: December 31, 2008
• Case Number: F-2007-00327
• Publication Date: January 20, 1960

(b)(3)
(b)(6)
Standard Form 513
Rev. August 1954
Promulgated
By Bureau of the Budget
Circular A-32
CLINICAL RECORD .I CONSULTATION SHEET
.5cue/4 i5 off" 1% EYe
EYE CLINIC
39223
DATJ N, 2 Q 196
PLACE OF CONSULTATION
^DEDSIDE DON CALL.
l~ Nan/e
2PHTHALM0 LO
APPROVED FOR RELEASE^DATE:
1 O-Nov-2008
SIGNATURE AND TITLE A7
PATIENT'S IDENTIFICATION (For typed or written entries give: Name-last, first,
middle; grade; date; hospital or medical facility)
C'.I1,?I7 J6 1 ? of//o,sJ- C C.
&U/6s /1
REGISTER NO.
EMERGENCY
0 ROUTINE
Ape.? 7
CONSULTATION SHEET
Standard Form 513
~`( U. S. GOVERNMENT PRINTING OFFICE : 1957-0-437819 16-56119-5 t I
IDENTIFICATION NO.