Officers and Other Ranks leaving the service for reasons other than medical unfitness are to be reported on this form.  Where there is evidence of any undetermined or pogressive disability; this form will not be used, but the case will be referred to a Medical Board for completion of M.F.B.

No. 772842   Spr   Surname: JURY,  Given Name: Arthur Francis

Unit or Corps: CRTD       Birthplace: Brantford

(Examination of Officer or Other Rank (stripped) to be made by one Medical Officer.)

General Description:

Physique: Good  Weight:  135 lbs.  Height: 5 ft 4 inches  Colour of eyes: Blue

Nutrition: Normal

Pulse: 72

Condition of arteries: Normal

Vision: Rt. 6/6  Left: 6/6

Hearing (conversational voice) Right: 21 ft.  Left: 21 ft.

Opinion asz to general health and physical condition: fit

Has Officer or Other Rank ever suffered from, or has he now, any affection to the following systems?  Answer yes or no.

Nervous System: No    Genito Urinary System:  No   Cardio-Vascular System: No

Special Senses:  No   Integumentary System:  No        Respiratory System:  No

Disturbance of Mentality:  No   Muscular System:  No  Digestive System:  No

Osseous and Joint System:  No   Any other general condition: No