CONSULTATION SHEET - CARANCI, JOHN C.
Document Type:
FOIA [1]
Keywords:
PERSONNEL FILE [2]
CARANCI JOHN C [3]
Collection:
FOIA Collection [4]
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
Sequence Number:
Case Number:
F-2007-00327
Publication Date:
January 20, 1960
File:
| Attachment | Size |
|---|---|
 DOC_0001415066.pdf [5] | 47.14 KB |
Body:
(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.