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HomeMy WebLinkAbout1055 5J'.S~' ORANGT DEPARTHII~IT OF BEALTB ~:~I' ORAi~1G~, NEW JERSE!? 1~5~7.7~i . i,:~der ~ hand and Departraent SeA1 I certif~ that this is a true rhotostatic reproduction from Rn imag~e of the original record.. r .-,•>.r~~±. r .,x• , + , ~ } ~ ~ 1AN 2 91969 ,a..... _;,.i::7: , c•~ ~ . Rober ;j~e, ~ - , . , y: t _ oa ~ . t~; ~ ,`f W Fegistrars~ ~ } - ~~Q vs~' ~~~~a~~,,,~;,~i?~'~`{~~' ° ~L ~ ~ ~ r ~p t~,~ ~IY~ y' °G ~ t:. ~ ~ c~0 Nf7~ ACC.,PT THIS TRANSCRIPT DNLESS TQ1~ ' t F ~ F +r~ n~;~ ~i : i +~c ~7~~ " ~~I(~. • i J ~ C~ v Z a = ~tAIS~D SERL OF THa CITY HEALTH DEPARTl~4F1~IT :~~t'1.~,,'"'= ~~I-':~"r ••~x;~'.s:: r:'~` : ~ ~t,3 ~ o3.S ~<es..c' Y 't~r'.?,~'•'.,~~'~ - ~ p } (L ~ ~'F'~Z~uD ~ s : ; . ~o. .ti~Ytit ~ G i ` ~ 0 G Q ~ ~ ' ~ . T~ s, i~ - . ~ ZW~: ~ iti V . •±~~'`'Q~ ,1:~F d'~ ~ ~ ~t ~ d G ~ ti~ Y • i~, , g~s ; : UV p t~.. -t:~.~.~;:_'.: ~',LL' ~ ~'~`~~'•K~r'R:z~~:~~ : r~~ JJ ll1 • •-r'. ~j~.,. W y~ ~ { . y~ ~.~~'t - i if~ ti r • ~ E~ - . !fr.; ~ir . i ..f-Y'-~.`•`R' lN ~ „i . - . S7ATE OEPAR7~iENT OF MEAITM 01° NE~ JERSEY - , - , i' i?IA:E Of pEATN Z. USUAL ~F,SIOB~CE IfArre ~ece~s~J li.t{. q iwi~ti~c ertsi~enc~ aelwe .'~.;ac h tO~.~TY ESSBX S71TE ~Ue'~/ J~' R COUMY S8OaZ ad~.is.owl. ~ t~. CS:I' g~ (fAtck boa a~d Rir~ Yw[l LE.IIGTH QF c. CITY ? iClurk M~ wM ~i~t ~~sl ~ FGR~IiGH STAY ~A~+ pl~~? f„~ . C flO1lOlIGH ~_J TOT~rii? East ~range 50 days m.~v~~P ~ South 0 e .t. F~ Ll ~.1lIE OF ;li ~w .a Y.uspM~: o~ ~asiie.r~ow, Ri•e v~e~~ ~ddress or d STREET . ; hGS?t7Ai AR AppRE.« !I r~al. P.O- Address _ ,.~-r~?zb. Veterans adminisLration _ Blancha . ---a-.}:r~•~ b. V~dJ!el c. ~l.as~~ Ili~t\~ (DsT) IY~~n 1.x:+.E OF ~ATE . , DfC?wSEO 41~3`~h ~~.l,~r pf ~ . : . . ouTM - 9 9 6? - - . ' . ~ ~ ; • . ~ r . . F x t uarneC ~ \~.e~ 4arra • , : .~A, (}att of 8ut~ 9. 1~t /I~ yr~.s U ~wdtt 1 Y~t. t( aneer~ a'~ Wa. i . ~ /~sy?~u41 lbrb IM~a Hw.~ 1 v.t ..31~ WAl~ e ~ ' ~ r•,.M:.• p ~ a_i'. 'X<yuo.+n • v t,er ::J'~. Aual of P~a.ne~• s(ndr.~rr I1. NutA{~I~ct f{!«~ •r lornM towfql 12. C~tii~e~ ~f T~at Co~w[t~ ~ ~ . u~n.,~ ~nt~ o~ rwa~~s•L~~. .•~t~rrAN, ! ~:::.~.eur i~T1RE0 ~ Nex Jeree~ ~ U.S,A. F~.`.~rs N~e ~ U. Vn~?t+b Ww1eM \~~e Cr~:~.~ies f~.L~ . ~ Mna Cibsoa i.• za~ : ec~aaed E•er m 1.~ ~.~ea Forc~s~ I(ti ~oc~a: •=erwny \ 1'.. ~11fORMRNT .1/Iress . ~ ~l~s. wv..r 4wbv.~wiftlf ~['ri ~~ro.,I~ps ~S ~r.t.~ ~ . ~ Yes : yy'orld ~tiar I 1 1 Veterans ~~iniAtrati+on 8eoords c..s[ ~ , : ltl. GUSE OF OE~TM , t~t~. wJy uK arss~ l~•:~+~ /a~~t ~b ~+I it latehal be~~ee~ ~ f Pan 1. D?xA ta~ l~u~ed Pr: •yDAC.yO~@~~l'i+a ~ O~~ ~rl Oe~t? ~ ~ ~miwnt.s~t ('•:aat •..f •7i- il t • . - ~ Ca~irux.s, ~/w~ llwe in M~ + ..4.t1~ ~~~e ns~ f<~ . •~O[ I fOil t fI~ ~ ~ ~ st~u~j tb ta~u- ~ ~ i~. ~ ~ ~+R coeilas~, :i:,e Tu . - - _ ~ i Pxe IL Ocber ~.t~~r~cin~ :'~.w.n.~n. ~.arrrr~.R ~e hr.~l~ BM Kw ~Na~J w J`e Tenauul Diu~~e C~wd'wio~ Gnew i~ P~w W? H. ~u A~rops. A.~-ter~caclerotic Hf's~T't D1393S6 ~ Y C r~.~T ' - ~ - s t 2ps. 4cc:drir ~rx ~p~ Hos.c:.k !?ON. descrdr Hu~ M~~ Ocarred. rEr~. •rw o~ .~pry Pwr 1 0. P~ !J ~e~ Ii) W j ~ - V , i_I 1 ce • ~ ~ tJv F.o .i n2.~aso+1~l:t. j . •cc~oa.. ~ ~ ~ 2Je. 7.ae el Mu~. Kwk O~r. 1'~~r ~ ln~uT G ~ ~ r-s Y ~ ; 2~M. la,Yryr OteYr.ec i:ue. i+:icr of ln,ur. I~. t.. o~ ~for ~++r. ]d. Cw~, TN~ ~f I.KMw11 Sar~ iA.:e ~t ~ ~n ~~r r . .'~~urr.~l..`I.ol;rc~ W~.. wf.1 •wk ~ q~---[ 2:. ~uraJ`~ ~7Y:~:'..:~:. v.~r~~Gi~ .n_~1 ~~j']'~J ~ ••ai~~~ • , ~~T~~t~ er~aRil u j~~.`"_'` rw ~w~ l~t~ itr~/ ~iw~: af N N~ bu .~r 1+~+..(e/s~. !ro~ ~ r~u~~ at«~~ ~ ~ j~~iG~1AT1R[ ~ ..a--=- - . 17r. O~er ~ ~ - .:.:x-. y. . ~ i os~~~, s. c~~o, ~a ~ , a. Lvii, Ge..~..w, i'>~a----~ f 2. X~+~s d Cs~«rl r ~~T ]3L r~ lCie~, pw ~r ew~eyl lfrr~j •~v ~ Y.} " *eao'allS ~t~)YI 2 S~~'Ti3 1y's GdTg o~'y~ivv~.v ~yA•vo~.r.~ N. - ~ :c;~~~: .r. _ - x. u~... w. A w. a.o+. r~ ~.cr ~ ki^ , a6a~W.U f~11 ? , . . . - - ~ .r -'~+r~._.~.~eX . . Y,.~-.,~... . . . . ' . • ~•r j ji•7(. . . . ' _ . ~ _ . . . . i. Y~ . . . . ' ' ~ . L.s~?ilii~? .at .r~riu.s. tl?rios ~r . p:iutis~ .s.a~i.t.e~.~? is tii. . 1~~~ - daa~a?~ t~r d~rtiLdt~. . . - - ~ ~ ~ ~ ~1~'f~'~~F~"F~*~".".~. Y atl.z'i ~{~MC_u1'?Y`,...- ~ ,.a- _ . . ~ .•'-r~_..~z~aiYrka ~b'a"~ c.~ v~i i.~k>'-c^G ~~.r