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Ford, Gerald - Interval Six-Month Physical - July 14, 1976
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81556730
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Ford, Gerald - Interval Six-Month Physical - July 14, 1976
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Betty Ford White House Papers
First Lady General Subject Files
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Ford, Gerald R., 1913-2006
Presidential health
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1976-07-01
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1976
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1976-07-01
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The original documents are located in Box 37, folder "Ford, Gerald - Interval Six - Month
Physical - July 14, 1976" 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of America her copyrights in all of her unpublished writings in National Archives collections.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.
July 14, 1976
MEMORANDUM FOR MR. RON NESSEN
The President is 63 years old today and completed a six-month
interval physical examination this morning in the White House
Medical Office. His last complete physical examination was
performed on January 27, 1976 at Bethesda Naval Hospital.
The results of the laboratory tests and physical examination
today were completely normal and I have found the President
to be in excellent health. He has had no complaints during
this period other than mild discomfort in his knee following
periods of prolonged standing. The President has maintained
his physical capacity for working long hours. He sleeps very
well and continues to follow his diet and weighs between 195
and 198 pounds. The electrocardiogram was normal and the
blood pressure 120 over 72. His cardiovascular functions
remain excellent and he continues with his early morning
exercise program and evening swim.
The President feels exceptionally fit and is looking forward to
continued good health.
William M. Lukash, M.D.
Rear Admiral, MC, USN
Physician to the President
PRESIDENT GERALD R. FORD
INTERVAL SIX-MONTH PHYSICAL EXAMINATION - July 14, 1976
AGE 63
The President has had no significant complaints since his last
examination other than a discomfort in his right knee which resulted
from a strain while playing tennis with his family on March 8, 1976.
This has been treated with ultrasound and Butazolidin. He has
gradually increased his quadriceps strengthening program and is
much improved. There has been no effusion for several weeks.
The joint itself remains quite stable. He has no other complaints
and has had no rectal bleeding during this interval. His general
capacity for work and long hours has been unimpaired. The
physical examination revealed no abnormalities.. He weighs 198
pounds; blood pressure 120/72; pulse rate 67; temperature 98. 2:
There were no abnormalities on his physical examination and all
findings remain unchanged since his last examination. Measure-
ments of the thighs taken from a point eight inches above the tibial tub-
erosity showed a diameter of 18 inches on the left thigh and 17½
inches on the right thigh. The electrocardiogram was normal.
The blood count, SMA-12 and SMA-6 were all within normal
limits.
In general the President is in good health and no recommendations
regarding the results of his physical examination were necessary.
wf
William M. Lukash, M.D.
SPECIMEN/LAB. RPT. NO.
HEMA-
FORD, President Gerald R.
TOLOGY
The White House
URGENCY
PATIENT STATUS
ROUTINE
BED
AMB.
372-28-6532
OUTPATIENT
X
TODAY
NP
DOM.
PRE-OP
SPECIMEN SOURCE
X
VEIN
CAP
STAT
X
OTHER (Specify)
Enter in above space:
PATIENT IDENTIFICATION-TREATING FACILITY-WARD NO.-DATE
REQUESTING PHYSICIAN'S SIGNATURE
REPORTED BY
MD
DATE
LAB. ID. NO.
Wm. M. Lukash, M.D.
TECH
REMARKS:
AUTO-
METHOD
MATED
rare
ATL
rare Aniso
Part +
(X)
MANUAL
76 0700
REQUESTED
RBC COUNT
WBC COUNT
IMMATURE
NEUTRO-
BANDS
NEUTRO-
SEGS.
LYMPHO-
CYTE
EOSINO-
PHILS
BASO-
PHILS
MONO-
CYTES
PLATELETS
RBC
SED. RATE
TEST($)
HGB
HCT
PLATELET
COUNT
RETICULO-
CYTE COUNT
CLOTTING
BLEEDING
CONTROL
PATIENT
CONTROL
PATIENT
ACTIVITY
HEMATOLOGY
%
RATIO
SPECIMEN TAKEN
TIME
TIME
SICKLING
P
1
1
axo
ЕШ(пшой)
TEST
LE PREP
TIME
ME
MCV
MCH
MCHC
Standard Form 549 (July 1971)-GSA GSA FPMR 101-11.8
(x)
X
X
X
DATE
7/14/1
RESULTS
4,79
15,5
44,9
617
3
60
31
6
Adeq.
SPECIMEN/LAB. RPT. NO.
FORD, President Gerald R.
CHEM I
The White House
URGENCY
PATIENT STATUS
372-28-6532
395 2000
BED
AMB.
ROUTINE
OUTPATIENT
X
NP
DOM.
TODAY
SPECIMEN SOURCE
Chf
PRE-OP
X
BLOOD
STAT
X
OTHER (specify)
Enter in above space: PATIENT IDENTIFICATION - TREATING FACILITY- WARD NO.- DATE
REQUESTING PHYSICIAN'S SIGNATURE
REPORTED BY
MD
DATE
LAB. ID. NO.
Wm. M. Lukash, M.D.
TECH
REMARKS
0955
AUTOMATED
METHOD
(*)
MANUAL
DATE TIME 76 0700 A.M. P.M.
REQUESTED
TEST(S)
GLUCOSE
UREA N.
CREATININE
URIC ACID
SODIUM
POTASSIUM
CHLORIDE
PROFILE (specify)
SMA-6
CHEMISTRY -
CO2
PHOSPHATE
CALCIUM
TOTAL
PROTEIN
ALBUMIN
GLOBULIN
PHOSPHATASE
ALKALINE
PHOSPHA-
TASE-ACID
SGOT
LDH
CPK
BILIRUBIN
(TOTAL)
BILIRUBIN
(DIRECT)
CHOLESTEROL
TRIGLYCERIDES
BSP
AMYLASE
LIPASE
SPECIMEN TAKEN
(X)
X
STANDARD FORM 546 (JULY 1971)-GSA FPMR 110-11.8
7-14-
RESULTS
97.
16.6
139.
4.1
104,
26.
Standard Form 514
Rev. August 1954
Bureau of the Budgot
Circular A-32 (Rev.)
CLINICAL RECORD
LABORATORY REPORTS
ATTACH 3D REPORT ALONG HERE
AND SUCCEEDING ONES ON ABOVE LINES
ATTACH 2D REPORT WITH TOP AT THIS LINE
ONG LEFT MARGIN WITH TOP AT THIS LINE
ATTACHING MARGIN
FORD, President Gerald R.
The White House
SPECIMEN/LAB RPT. NO.
MICRO-
372-28-6532
025700
BIOLOGY I
PATIENT
INFECTION
STATUS
ADMITTED WITH
BED
HOSPITAL ACQUIRED
AMB
PRE-OPERATIVE
X
OUT PT.
POST-OPERATIVE
NON-SURGICAL
Enter in above space:
IN
DOM
POSTPARTUM
REQUESTING PHYSICIAN'S SIGNATURE PATIENT IDENTIFICATION-TREATING FACILITY-WARD NO.-DATE
NP
NEWBORN
Wm. M. Lukash, M.D.
REPORTED BY
OTHER (Specify)
DATE
CLINICAL INFORMATION (Include Specimen Source)
MD
LAB ID. NO.
urine
14 JUL 76 20 6
05
ANTIBACTERIAL THERAPY
A.M.
P.M.
LABORATORY ARTMENT
COLONY COUNT
BE HESDA. MARYLAND 20014
NAVMED NNMC
SPECIMEN TAKEN
7/14/76
EXAMINATION 0700 REQUESTED
CULTURE
COLONY COUNT
TIME
PREDOMINANT ORGANISM(S)
200
/ML
X
OF URINE.
DATE
SENSITIVITY
SENSITIVITY
Streptococci
MICROBIOLOGY -
SMEAR
PATIEN
REPORT:
the:
7/15/74
Standard Form 553 (July 1971)-GSA FPMR 101-11.8
X
1.
The
2.
PORTS
Standard m 514
514-104
Stock No. 0109-201-2701
SPECIMEN/LAB RPT. NO.
FORD, President Gerald R.
MICRO-
BIOLOGY I
The White House
025700
PATIENT
INFECTION
372-28-6532
STATUS
ADMITTED WITH
BED
HOSPITAL ACQUIRED
PRE-OPERATIVE
AMB.
POST-OPERATIVE
X
OUT PT.
NON-SURGICAL
DOM.
POSTPARTUM
IN
NEWBORN
NP
OTHER (Specify)
Enter in above space:
PATIENT IDENTIFICATION-TREATING FACILITY-WARD NO.-DATE
REQUESTING PHYSICIAN'S SIGNATURE
REPORTED BY
DATE
LAB ID. NO.
Wm. M. Lukash, M.D.
MD
ANTIBACTERIAL 05 THERAPY
CLINICAL INFORMATION (Include Specimen Source)
14 JUL 76 20 6
urine
LABORSTORTELICATHENT
A.M.
P.M.
BETHESDA.
SPECIMEN TAKEN
0700
CULTURE
COLONY COUNT
COLONY COUNT
7/14/76
EXAMINATION REQUESTED
PREDOMINANT ORGANISM(S)
200
/ML
OF URINE.
TIME
X
SENSITIVITY
"streptococi
MICROBIOLDON -
SMEAR
SENSITIVITY
7/15/74
Standard Form 553 (July 1971)-GSA FPMR 101-11.8
DATE
REPORT:
M
X
1.
2.
Standard Form 514
Rev. August 1954
Bureau of the Budget
Circular A-32 (Rev.)
CLINICAL RECORD
LABORATORY REPORTS
ATTACH 3D REPORT ALONG HERE
AND SUCCEEDING ONES ON ABOVE LINES
ATTACH 2D REPORT WITH TOP AT THIS LINE
ATTACH 1ST REPORT ALONG LEFT MARGIN WITH TOP AT THIS LINE
ATTACHING MARGIN
ATTACH ALL TEST REPORTS TO THIS SHEET
PATIENT'S IDENTIFICATION (For typed or written entries give: Name-last, first,
REGISTER NO.
WARD NO.
middle; grade; date; hospital or medical facility)
PLATE NO. 14752
LABORATORY REPORTS
Standard Form 514
514-104
Stock No. 0109-201-2701
PATIENT CUMULATIVE REPORT
DL(fita
111111 FORD, GERALD
00 372 28 6532 WH
7/14/76
DATE
7/14
TEST
NORMALS
UNITS
SMA-12
BLOOD
(0852)
ToT PROT
6.0-
8.0
GM%
6.4
ALBUMIN
3.5-
5.0
GM%
4.2
CALCIUM
8.5-
10.5
MG%
9.2
PHOS
2.5-
4.5
MG%
4.0
CHOLEST
150.0-300.0
MG%
285.
BUN
10.0- 20.0
MG%
16.
URIC AC
2.5-
8.0
MG%
7.5
CREATNIN
.6-
1.4
MG%
1.2
TOT BILI
.2-
1.0
MG%
.6
ALK
PHOS
30.0-
85.0
MU/ML
55.
LDH
100.0-225.0 MU/ML 213.
SGOT
7.0- 40.0 MU/ML
27.
STAT CHEM
BLOOD
(0852)
GLUCOSE
80.0-120.0
MG%
97.
BUN
10.0- 22.0 MG%
16.6
NA+
135.0-145.0 MEQ/L 139.
K+
3.5- 5.0 MEQ/L
4.1
CL
95.0-108.0 MEQ/L
104,
C02
21.0- 27.0 MEQ/L
26.
LIPIDS
BLOOD
(0852)
CHOLEST
MG% 285.
TRIGLYC
MG%
305.
STAT UA
URINE
(0851)
COLOR
YELLOW
APPEARNC
CLEAR
SPC GRAV
1.015
BLOOD
NEG
KETONES
NEG
GLUCOSE
NEG
PROTEIN
NEG
PH
6.0
RBC'S
/HPF
NONE
WBC'S
/HPF
RARE
FPI'S
/HPF
RARE
AMORPH
FEW
CBC STAT
BLOOD
(0852)
WBC
5.0- 10.0 K/CMM
6.7
RBC
4.7-
6.1 M/CMM
4.79
HGB
14.0-
18.0
GM%
15.5
HCT
42.0-
52.0
VOL%
44.9
MCV
80.0-
94.0
CMI
93.
MCH
27.0-
31.0
MMG
31.8 #
MCHC
32.0- 36.0
%
33.7
111111 FORD, GERALD
00 372 28 6532 WH
7/14/76
PATIENT CUMULATIVE REPORT
111111 FORD, GERALD
00 372 28 6532 WH
7/14/76
DATE
7/14
TEST
NORMALS UNITS
DIFF STAT
BLOOD
(0852)
STAB
.0-
.0
%
03.
SEG
51.0- 67.0
% 60.
LYMPH
21.0- 35.0
% 31.
MONO
4.0- 8.0
% 06.
PLATELTS
ADEQ
ANISO
RARE
POIKILO
1+
ATYP LYM
RARE
PERMANENT REPORT - RETAIN ON CHART
111111 FORD, GERALD
00 372 28 6532 WH
7/14/76
Birdick
Burdick
avr
:
V3
)
Burdick K EK 10 EK-10
V6
2
aVL
V2
NWWA
V5
aVR
LL I
) K EK 10"
EK-10****
VR
V1
V4
3
n EKi10.*
III
PATIENT
PATIENT Ford, Gerald R.
DATE 14 July 1976
ADDRESS Whate House
AGE
SEX M
HEIGHT
WEIGHT
LINEAR
TELEPHONE NO.
BUILD
INTERMEDIATE
LATERAL
OCCUPATION
BLOOD PRESSURE 124/72
DOCTOR(S) Johnsh
HISTORY
MEDICATION
PATIENT POS.
P WAVES
ECG NO.
AURIC. RATE
T WAVES
VENT. RATE
S-T SEGMENT
P-R INTERVAL
RHYTHM
QRS INTERVAL
ELEC. AXIS
CASE NO.
Q-T INTERVAL
ELEC. POSITION
FINDINGS
uncharged normal /DL
REMARKS
DATE
THE BURDICK CORPORATION Milton, Wisconsin 53563 U.S.A.
007857
7306 PRINTED IN U.S.A.