CONSULTATION SHEET - CARANCI, JOHN C.

Document Type: 
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
Sequence Number: 
Case Number: 
F-2007-00327
Publication Date: 
January 20, 1960
File: 
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PDF icon DOC_0001415066.pdf47.14 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.