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A blank two-page medical questionnaire and physical examination form titled "Asbestos Workers Health Hazard Survey," from the Medical Department of Union Carbide's Institute Plant. Page 1 asks about work history with asbestos, personal respiratory and general health history, and smoking history. Page 2 provides fields for vital signs, lung function (FEVC), laboratory values, an X-ray report and a physician's chest examination. No worker's name, date or answers are filled in.
- Published by
- Union Carbide Corporation, Institute Plant, Medical Department
- Series
- Union Carbide documents, UC-3414
- Number
- Bates UCC 017193 to UCC 017194
- Library no.
- ACL Doc 18177 · asbestosclaims.law/library/18177
- Rights
- A document from asbestos litigation, published for research and historical study.
Read or download
Read online Download the PDF Document UC-3414 · 2 pages · 99 KB
People and organizations
- Institute Plant (its organization)
- Union Carbide Corporation (its organization)
About this copy
This is document UC-3414 of the Union Carbide documents, documents produced and used as evidence in asbestos lawsuits against Union Carbide, 2 pages. Production numbers UCC 017193 to UCC 017194.
Cite this document
“Union Carbide Institute Plant Medical Department Asbestos Workers Health Hazard Survey Form (blank).” Union Carbide documents, UC-3414, Bates UCC 017193 to UCC 017194. Union Carbide Corporation, Institute Plant, Medical Department. AsbestosClaims.Law Library, ACL Doc 18177. https://asbestosclaims.law/library/18177.
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