Section 280. Certificate of exemption from combatant service. LOCAL BOARD FOR..... This is to certify that.... Date.. Order No. ......, Serial No. ......, has been found to be exempt from combatant service and is eligible only to such military service as may be declared noncombatant by the President of the United States. Section 281. Notice to registrants to appear for physical examination. NOTICE TO APPEAR FOR PHYSICAL EXAMINATION. LOCAL BOARD FOR.. (Date.) You are hereby directed to appear before this Local Board for physical examination at ...... m. on Failure to do so is a misdemeanor, (Date.) punishable by not to exceed one year's imprisonment, and may also result in your losing valuable rights and your immediate induction into military service. 1. Have you found that your health and habits in any way interfere with your ability to earn a livelihood? If so, give details... 2. Do you consider that you are now sound and well? If not, state details... 3. Have you ever been under treatment in any hospital or asylum? If so, for what ailment?....... Names of hospitals or asylums.. Dates of admissions and discharges.. 4. Have you been confined to your bed at home under a physician's care within the past year? If so, for what ailment and for what length of time?.. Name of physician.... When.... I certify that the foregoing questions and my answers thereto have been read over to me; that I fully understand the questions and that my answers thereto are correctly recorded and true in all respects. I further certify that I have been fully informed and know that making or being a party to making any false statement as to my fitness for military service renders me liable to punishment by imprisonment. (Signature of person examined.) PHYSICAL EXAMINATION BY EXAMINING PHYSICIAN OF LOCAL BOARD. Weight..... (Person under examinati 1 stripped.) lbs.; height .......... inches. Girth of chest (at nipples): At expiration ...... inches. At inspiration Genito-urinary organs (urine will be examined in suspicious cases). inches. Teeth: Missing Upper, 8 7 6 5 4 3 2 1 teeth..Lower, 8 7 6 5 4 3 2 1 Remarks... 1 2 3 4 5 6 7 8 Strike out those that are 1 2 3 4 5 6 7 8f missing. SPECIAL ENTRY.-Particular qualifications of registrant found to be physically deficient and not physically qualified for general military service (note hereunder any trades, professions, or other civil occupations in which the registrant has had experience).. I certify that I have carefully examined the person named on the first page hereof and have carefully recorded the results of the examination, and that it is my judg[physically qualified for general military service. physically qualified for special or limited military service physically deficient and not physically qualified for military service by reason of. Place.. Date... .M. D. Examining Physician. APPLICATION TO BE SENT TO MEDICAL ADVISORY BOARD. I hereby make application to be sent to a Medical Advisory Board for further physical examination. Date. (Signature of registrant.) REFERENCE TO MEDICAL ADVISORY BOARD. Respectfully referred to Medical Advisory Board...... for further physical examination of the person named on the first page hereof. Place... Girth of chest (at nipples): At expiration ...... inches. At inspiration inches. Genito-urinary organs (urine will be examined in suspicious cases). I hereby certify that the person named on the first page hereof has been carefully examined and that the results of the examination have been carefully recorded and that it is the judgment and belief of the Medical Advisory Board that he is— [physically qualified for general military service. physically qualified for special or limited military service as. physically deficient and not physically qualified for militray service by reason of...... Place.... Date.. (Designation.) |