When the information is not

This page may be completed by the physician's preceptor (if any) in the medical use of radioisotopes.
furnished by the preceptor, the name and present address of the preceptor (if any) should be shown in item 12 below.
9. (a) USING PHYSICIAN'S NAME
(b) NAME AND ADDRESS OF APPLICANT (If different from 9(a))

1. Examination of patients to determine suitability for radioisotope diagnosis and/or treatment and recommendations on dosage to be prescribed. 2. Collaboration in calibration and administration of dosages including related measurements and plotting of data.

3. Active period of training and experience of sufficient duration to permit followup of patients through treatment and posttreatment period including reevaluation as to effectiveness and complications.

4. Study and discussion of case histories to establish most efficacious diagnostic and/or therapeutic techniques for this radioisotope use.

12. THE TRAINING AND EXPERIENCE INDICATED ABOVE WAS OBTAINED UNDER THE SUPERVISION OR GUIDANCE OF

To renew the charge, book must be brought to the desk.

DO NOT RETURN BOOKS ON SUNDAY

DATE DUE

APR 3 1967

Form 7079a 3-53 5M S