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OCR Page 1 of 3Sillsbury, Mr. J. H.
418 Lakesdide Ave.
orange, N.J.
1. OCCUPATION
Crystalizing Lab. One year
2. AGE
32 years. Married.
3. FAMILY HISTORY
Negative.
4. PERSONAL HISTORY
Scarlet fever
5. PHYSIQUE
Heighth 5ft. 9in. Weight 1421bs. Posture good.
6. CIRCULATION
Pulse 80 regular, Bd. P. 145/90 , Heart sounds clear
normal.
7. LUNGS
Slight cough at times.
8. GASTRO INTESTINAL
Hormal
9. GENITO URINARY
Denies V.D. Normal.
10. NERVOUS SYSTEM & BRAIN
Healthy
Relations
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