English Translation

MEDICAL CLEARANCE CERTIFICATE (31) SUpplementaRy REcord 33 3 3 Temporary 3 3 3 1st pug D.D. T. aaee AL 63 M. K. HEAT. OTHER (25) Dates of Disinfestation Types certificate NO COINO ISN issued: (26) (27) TC ARRivaL Number Type Date Signature of Authority Can Date Initias L. M. C. D. T 1. 2507 By (Epid) 2. 3. 67 ME Remarks D. 1. No. S PaepaZuceril 3. 0 M Is Lt. AA 8. Cot Initials Reaction Vace. <94 I. V. VA. Read. Arrival Medical (28) Final Medical Inspection -: Inspeetion -: Date Date oro Medieval Examiner (29) MOVEMENT AUTHORIZATION (30) REcEPTiOn CEntER or VISA RECORd SOONE SEP 22 1955 N7/:281935 ON 1 7.1c.52 10-D97S1-1 U. 8. GOVENMMENT PMIMTING OFFICE