HomeMy WebLinkAbout31949 / 82-11m
June 17 , 1982
PURPOSE: E`CTEND RLTIR�MEVT DATES
INITIATED BY: PERSONNEL DEP9.2TMENT
� 11 RESOLUTION
WHEREAS, the City of Oshkosh, on the 6th day of December, 1979, adopted a Uniform
Extension Policy for employees of the police and fire departments; and
WHERFAS, the following fire and police department personnel have met the requirements
of said Uniform Extension Policy and have �equested a one-year extensi.on of thzir .
employmant:
: CARLTON PAULUS - 2nd Request - Fire Department .
Date of Birth: July 18, 1926
Original Retirement Date Is: September 30, 1981
Employment Extension Through: September 30, 1983
Calvin Phillips - 2nd Request - Fire Department
Date of Birth: July 24, 1926
Original Retirement Date•Is: September 30, 1481
Employment Extension Through: September 30, 1983
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that the
foregoing extensions are hereby granted.
- 11 -
SUBMITTED BY
APPROVED
---+
�
_.
NYAL M. SCHEUERMANN, M.D. S.C.
400 CEAPE AVENUE
P. O. BOX 20I6 �
OSHKOSM, WI t4B03
June 1� 1982
To whom it may concarn Re: Carlton Paulus
This is to certify that Mr. Carlton Paulus was examined
on Monday June 1� 1982� and he is fit to continue with his
present employment.
NMS:kk
� ,;
�, (
�°\
,
� �
� �
�.
�� ;
�
; �.
�
�.
,1 � '
-� n
\ �\
\ �
t �, \
� �.
� � ��
\^ l
� , �
<<, '� �
�,� �
,.
\ '� �
� ��
\. � ��
�\ �
�, ; .
., ^ ,
\�
� �.
����\
�.
.�
,
,�
;
N
n
\
N
�
�
�.
�l/
S' ed� ` ^
0�\ \
lC7�,-�J
(
Nyal M. Scheuermann M.D.
\ �
,�
^ , `� \
. �
�1 �
, �� �
,,
�
: ;�
�` " .
� ^� -
`,
; �
; \
� \�.
.
�
,; _
�
%
\,
, �\�
�,. �
: �
,
� �
� ,�
� ��
�; �
,�
j� •�
v�
.�`.�1���
� . O` . rl" ..(:13f
�,,,�_�f..'�- -.i
May za, ieaz
Mr. William Frueh
Members o£ the City Council
City Hall
Oshkosh, Wi 54901
Dear Mr. Fnieh and Membera of the City Council,
=0li" _MANN r � a ' .
�:: '°
�J "
I hereby request an extension of employment with the Oshkosh Fire Departmect
beyond my nozmal retirement date of July 24, 1982 to be exCended to Suly
24, 1983.
A statement from Dr. Scheuermann; my Family physician, is enclosed for
your information..
S�pcerely,�
`r c���w.-,�--�..�
Calvin Phillipps
Fire Chief
pqBGO d�<�+en: �
4
1222 W. Washinelon Hivd.
Los MBeles. Calit. 9966T
i213) 7D75131 LEM �R �o
__ . n 3000 A� „
Y G��
�TEsf��'
N�M HV�r
qDDAES
/�S�me�e�' AUDIOGRAM
�` pIGXT FJ�R 40W 6000
_ ._�„ �oo0 30� ,.
NORM�L �
5
10
15
N
a Za
V
d
O 3C
c
N ��
N
O
J
5
LO
3�
4'
5
IOwM ai'�w
)
0
i0
�
)�
�
THE MEDICAL EXAMINATION REPORT �j/
POLICE AND FIRE DEPARTMENT ,
i. xanu <Princ) ��(� r � n P� ��l; o a s 2. Dau of b�rth 7! a.'/ /�.6 3. A8 S�
4. S;gauure of a plicaa
/ ,a, i
. i
5. Heigh 6. Weigh� � 7. Ches� � 3 X ; , � 1 T
Wi�AOU� ahon' SaiPMd �Otdinu� do(Ln Expaaded .lobiii4 N���1
& Eyaight: Sndlin Ttic: I.eft 20/�Q. Righe 20/�t! � � Both 20/sn .
co�t�a to: ufr zoi�.Sz. x;sb� zo��_ soa, zo/ ?�
co�or �n. i�„L.r,,...a,
9. Heuiag: R ea•�.G�• .-L •�•n'�"�
!0.
1L Dencal saney: Muk teeth "O` if caPPed or piv �I" if�iss�g, "%" if carioufi ••F'• if faise v�"�"°�°`
$ 8 7 6O� Q 3 2 1 1 2 03 �� � 7 8 L Perfrct Gties sligh' �
(�sOOd Ilpaf• Gdtl IDit�Ce�d�.(�
'� O
8 7 Ob ' S 4O 3 2 1 1 2 Q3 ��� 7 8 C Pyorrhn � � �Tad dm^;^.�
li io 13. Thtoa- R.•J• �_—�
., 14. Thyzoi� � �.R.�+`Q�dv� � 15. Spe"` °j� .tA ...�.�.t Q
16. Lnngr. Check for rnhm; mberculoaia, broncLit'v, chas %ray fiadino �Q- %«- ���� �
.17. Harr. Cscdio-va+calar rys�e� l�S 'p�. (Lc�O IC�
pobe nr. %a... itlood prasnre: Systoli iattoli
18. f:asuo-intatinel tract: Lh3�Pl�sid� �' t /L-�-+� iL�--s--I-3_. `� � U" �i'
meck for gasctic
C,aLL bladda�a
19. Genito-atinu9: ve�en
Wass �tCi.� �2�-Q-�
gy�M-'7°— —
- � „
p. H ' - 21. Vaeicose V' � �
�� � � �(�(n«e twm) d/_ /^
22. Hands_ ""�"""'_'~`C 23. Feet�('�-�:��. ..c�. �.w0 —( l�
�� n� ���� (Elat o� a6c oe)
2�L Boue+ and join�- "`�-"— °"^ 25. Spin �`� -a�
26. D'uabilicid: (c6ronic amcrh, sinus, fistula. recnl dise%ui cataneom dise%se+. etc) � n•�[f-�•�SZ
�u �i
27. Illnex+ and ini:Fr+p4 .,
2& Openao q���`'`}'� "
29. Nencodc cendmd-c��*-- 4 =
30. Covld [hia maa perform dury involviug beiag on Lin fee[ for 12 houcs continu
31. Could tLi� maa pedorm dury involving long houn of dury involving sitting or
32. Re�e*kl _ . . � �
I HERggY CIILTIFY TFIAT TEILS IS A TAUH RECORD OP THH MEDICAL EXAMINA'IYOI�OF THE O^ EXAMII�TEE
c
AND 1T3AT I HA'VE FOUND HIl�f Q Q�FI� � PHYSICALLY FOR THH DVI'IES OF '� ��� � e> '
��� � l�. �.�....ti�7 ,t ti t�,f D.
Medical �emi�r
.. ... .............M...s_�..��
�
MEQ{CAL HISTORY STATEMENT
(To be rakea in presence of e�camiaing physician.)
#/ /
Do yon beliwe you ue somd and well now?_./tr�_=Are you subject to diuiaos?�To sevue headache? ��
/ .�1-` D
?o paia ia the braul�To 8uttering of the hear[1�To ahorcaas of bres�h?�,GL_SL�To coug6eT�
'io diarrLea7� To piles?__�te_s�_ To rheumadsm?.�L� Have you hed sore eyes or any defect of vicion?S..�G4:�t-rt �
Rantiag from ei�her ead.--.�—Is your unse of heariag goodt�? Have you had 6ts oc mnvalsiom?�
<
It so, Low freqamdy? �— Uamnscious spols7 .T%�� If so, how frequendy? -�
Aathm�? ,iL%D ♦ppendicitis? ,� -L.� w, wue You opented uPoo�-� �= 5• Gonoa6ea7 /I%�
�- A wn oE any Icind upon 9our P��T Q� 4 Whrn7
My swdlin8 oboat or of 9oac tenidal A%i) A boil anr rhe auus? (fistula)? N � —
Ha�e 7on been raptured? �C - S � A A ��� Do yon dridc iatoxiwtiag liquon to ezces�7 �(�
/
If not, m wha� �teud Do yon ase or have you used opium, morphiaq coniue, oc eny
o[hc uarcotics7 �� Whm? '-- Whst was the cause of Yout faehee's dea�ht�������'f�—
What �vas tfie ause of yoar mothels deatLt =•v� a� d—S'�1��/�- Has say membee of 9our family had tuberculosia.
insaniry, epilepsy. or inflammatory rheumstism.� ��v
Have you e�er spit blood? �� Have you ever been hurt npon the 6ead? �v
Aaswer follp
Hare 7oa had a epnia?�r S A sciff joint��=A bone oe joint ouc of plece?_�A bone b�okeat��±
Whu 6ames broken? "" Whrn? — fanse? —'- Are yon snbjecs w
�� �� ��x f�� t�� -�X[H-bT ��ry�JF/L T(1CMrotioa nrefiiliy injuria or surgical operatiom yoa may 4
have lud nP� my Pacc of your body. especiall➢ butus, can. severe bmisn. o: war womGSJ �/L 1��lNAIe.?�res�
u.3 A.1�� �7_�1T.SbT �„a--F �'q�TiL.,�rl_ �kD✓E f ST"o�t�`,
W6�[ hosPitaliution Lsve yoa Lad for U. S wat xrviceT �yf��lt/S � -
Give name aud addras of phys�dan who last sttmded yoo, for what a.lmeac,
7 herehy cerrify that the� foregoing stacemenes ue true to the besc of my kaowledge and belief.
Signarure of Applicaat
1a6��' '
(sig ll aame)
�
r--I
�
s'
; .,
�
0
.�
�
�
N N
+� 1a
W Ga ^
�
N I v
N
H v �
� � � �
o.� ro a
FC Q o ..
� �
o +� ¢ v
+> � •�
� o s+
� � � F �+
oa�G �
•�I N v U
1� •�I �
� � � �
�-f N Sa O
o a ro �.�
N p, +�
N W N O
aoQ �
N
W �i
rn �
� � S�
N
f� r-I
'-i U
`� � 'r�
h U