Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
81556725
label
Ford, Gerald - Physical Examination due to Ski Accident - October 30, 1973
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
81556725
sourceUrl
contentType
document
title
Ford, Gerald - Physical Examination due to Ski Accident - October 30, 1973
citationUrl
collections
Betty Ford White House Papers
First Lady General Subject Files
subjects
Presidential health
thumbnailUrl
largeImageUrl
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
81556725
coverageEndDate
logicalDate
1973-10-01
month
10
year
1973
coverageStartDate
logicalDate
1973-10-01
month
10
year
1973
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
fa53a2ea749dce7d
ocrText
The original documents are located in Box 37, folder "Ford, Gerald - Physical Examination
due to Ski Accident - October 30, 1973" of the Betty Ford White House Papers, 1973-1977
at the Gerald R. Ford Presidential Library.
Copyright Notice
The copyright law of the United States (Title 17, United States Code) governs the making of
photocopies or other reproductions of copyrighted material. Betty Ford donated to the United States
of America her copyrights in all of her unpublished writings in National Archives collections.
Works prepared by U.S. Government employees as part of their official duties are in the public
domain. The copyrights to materials written by other individuals or organizations are presumed to
remain with them. If you think any of the information displayed in the PDF is subject to a valid
copyright claim, please contact the Gerald R. Ford Presidential Library.
Standard Form 519
Rev. August 1954
Bureau of the
Budget Circular A-32
C 3-201-4602
O
10-30-73
NAME: Ford, Gerald
200 CU. CM
Cong. 1 Mich.
400
AGE: 60
600
HT: 72.in
FEVT 4975=5373 =
800
FEV1 3925-4239
1 LITER
FEV1 4,2Lor 78.8%
1200
FEV2 4475 - 4833
1400
FEV2 4.8Lor 89.9%
V.C. 4975 = 53 73
1600
-
PREDICTED 3805
1800
V.C. 5,4Lor 141%
2LITERS
2200
2400
2600
THE
2800
3LITERS
3200
FORD LIBRAR & 8075838
3400
3600
3800
4 LITERS
10-30-73
4200
PATIENT'S IDENTIFICATION (For typed or written entri
middle; grade; date; hospital or medica
4400
Ford, Gerald
4600
Cong. / Mich
4800
5 LITERS
Standard Form 513
Rev. August 1954
Bureau of the Budget
Circular A-32
S/N 0109-201-2602
CLINICAL RECORD
CONSULTATION SHEET
REQUEST
TO:
FROM: (Requesting ward, unit, or activity)
DATE OF REQUEST
ATTENDING PHYSICIAN'S OFFICE
6-11-73.
REASON FOR REQUEST (Complaints and findings)
U. S. CAPITOL
Pt sun in Capital affere by
FORD
hh Lanejay
SEHALDA
LIBRARY
PROVISIONAL DIAGNOSIS
DOCTOR'S SIGNATURE
APPROVED
PLACE OF CONSULTATION
EMERGENCY
BEDSIDE
ON CALL
ROUTINE
FREEMAN H. CARY are
CONSULTATION REPORT
RADM MC USNR
6-11-73
Rechech on knees
lateral memisitory Jane 1972, fall
on both knees an Jan, 20th with subsquent
e remision of effusion & mild residual disconfort.
effencion & pain. Incorrement Pattowing excresses
9
TO
Knee no effusion, mild eulloctered lakety laterdly
ant. of Cost crucute normal, no signs of menxial
laxity laterally. No sign of loose Body's on newsered
credites on no tion of pabela Omartes nor md, rick
no effersion, Dynorial Thicking &
remints.
I-Ostations Cost Lt. menisating
R
(Continued on reverse side)
SIGNATURE
DATE
IDENTIFICATION NO.
ORGANIZATION
PATIENT'S IDENTIFICATION of written entries give: Name-last, first,
REGISTER NO.
WARD NO. pace
middle;térade; date; hospital or medical facility)
Dip
Ford, Gerald
,
Continue excreises
CONSULTATION SHEET
Activity as tolono-ted
Standard Form 513
2
513-104-02
long (nuch)
w
Reckech RETURN TO
THE
ATTENDING PHYSICIAN
ROOM H-166
U.S. CAPITOL
Oz
OFFICE OF ATTENDING PHYSICIAN
UNITED STATES CAPITOL
WASHINGTON, D.C.
DATE
PROGRESS NOTES
5JAN73
PROBLEM: Injured lower spine.
SUBJECTIVE: While skiing he was able to use his knees without
difficulty, but was hit by a wild skiier on the back, causing
him to fall and injure his lower spine. It had been painful,
particularly on lifting and turning with some tenderness since
that time.
OBJECTIVE: No bruising or discoloration. Just at the crease
of the buttocks on the right side there is some tenderness.
X-ray findings show some irregularity to the right lateral
part of the mid-sacrum also on the lateral view a similar
questionable fracture line is seen, but on reviewing old
films it was present several years ago.
ASSESSMENT: Probably soft tissue injury or else refracture
of an area.
PLAN: Keep the stool soft, sit on a soft surface, avoid
heavy lifting. Will do fluoroscopy and repeat films if
necessary.
PROBLEM: Injured rib.
SUBJECTIVE: Mr. Ford also fell landing on his right elbow and
driving it into his right lower chest and for a while had tender-
ness of the rib area an X-ray of this area reveals no abnor-
mality. There is no deformity either on physical examina-
tion.
F. H. CARY, M.D.
wfw
9/25/73
Get pe 10/1/73 0900 Da Corry - John
FORD
DERALO
LIBRARY
N me:
FORD, Gerald D.
Congressman/Michigan
(Last)
(First)
(State)
(Allergies)
Standard Form 513
Rev. August 1954
Bureau of the Budget
Circular A-32
S/N 0109-201-2602
CLINICAL RECORD
CONSULTATION SHEET
REQUEST
TO:
FROM: (Requesting ward, unit, or activity)
DATE OF REQUEST
ATTENDING PHYSICIAN'S OFFICE
6-11-73.
REASON FOR REQUEST (Complaints and findings)
U. S. CAPITOL
Pl sun in Capital affire by
Lh Lanejory
PROVISIONAL DIAGNOSIS
DOCTOR'S SIGNATURE
APPROVED
PLACE OF CONSULTATION
EMERGENCY
BEDSIDE
ON CALL
ROUTINE
FREEMAN H. CARY Man
CONSULTATION REPORT
RADM MC USNR
6-11-73
Recheck on knecs.
Latoral memisiting June 1972, fall
on beth knees air Jan. 20th with subsquent
effencion 4 pain. Incorrement Pollowing excresses
e reminsion of effusion & mild residented discurfort.
05
7
and 1 Cot criente nor cl, no signs of memoral
Knee no efform mild collound lakety laterdly
miging 12 knee no sympoial Thinking 4
laxity laterally. No sign of loon body on memisal
cregition on notion of patiela Omicates not nd, mild
reminents.
I-o-station Cut LN. menisating
R
(Continued on reverse side)
SIGNATURE AND July TITLE
DATE
IDENTIFICATION NO.
ORGANIZATION
PATIENT'S IDENTIFICATION (For or written entries give: Name-last, first,
REGISTER NO.
WARD NO.
middle grade; date; hospital or medical facility)
Dif
Ford Genald
-
Continue exercises
CONSULTATION SHEET
Standard Form 513
2
Activity as toberated
513-104-02
3
Reckech CNN
7.5