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Two-page blank medical examination form. Page 1 is a keypunch-coded Medical Examination Form with columns for body systems, drugs, diagnostic codes and physician comments, with handwritten instructions on how to mark findings. Page 2 is a blank Preplacement Medical Examination History questionnaire covering family history, personal history, symptoms, service history and occupational history.
- Published by
- Union Carbide Corporation (UCC - C&P)
- Series
- Union Carbide documents, UC-1788
- Number
- Bates BRF 0330 to BRF 0331
- Library no.
- ACL Doc 16856 · asbestosclaims.law/library/16856
- Rights
- A document from asbestos litigation, published for research and historical study.
Read or download
Read online Download the PDF Document UC-1788 · 2 pages · 126 KB
What the document holds
- Page 1: Medical Examination Form (keypunch layout, form MRMS-4) with handwritten instructions on marking N, X and checked items (BRF 0330)
- Page 2: Blank Preplacement Medical Examination History questionnaire (BRF 0331)
People and organizations
- Union Carbide Corporation (its organization)
About this copy
This is document UC-1788 of the Union Carbide documents, documents produced and used as evidence in asbestos lawsuits against Union Carbide, 2 pages. Production numbers BRF 0330 to BRF 0331.
Cite this document
“Union Carbide Blank Medical Examination Form and Preplacement Medical Examination History (MRMS-4).” Union Carbide documents, UC-1788, Bates BRF 0330 to BRF 0331. Union Carbide Corporation (UCC - C&P). AsbestosClaims.Law Library, ACL Doc 16856. https://asbestosclaims.law/library/16856.
ACL Doc numbers and their short links never change. See how to cite the Library.
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