HomeMy WebLinkAbout31654 / 81-06December 17, 1981
PURPOSE: EXTEND RETIREPSENT DATES
INITIATED BY: PERSONNEL DEPARTMENT
1i 6 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
WHEREAS, the following police department and fire department personnel have
met the reqniremen*_s of said IInif�r•, Hst_nsion Pol.icy and hsv_ reques'_°d a
one-year extension of their employment:
DONALD MAND - 3rd Request - Police Department
Date of Birth: March 24, 1925
Original Retirement Date was: :�tarch 31, 1950
Employment Extension through: �tarch 31, 1983
GERALD SCHLENSKE - 6th Request - Fire Department
Date of Birth: February 25, 1922
Original Retireaent Date Was: March 31, 1977
Employment F.�ctension Through: March 31, 1983
ROBERT HABLE - 2nd Request - Fire Department
Date of Birth: February 24, 1926
Original Retirement Date Was: March 31, 1981
Employment Extension Through: March 31, 1983
NOW, THEREFORE, SE IT RESOLVED by the Common Council of the City of Oshkosh
that the foregoing extensions are hereby granted.
- 6 -
;?? �L�I'�^:'�D BY
-_ ..'D �
���.._.
o.:�
OSMIIOSM�
�
October 23, 1981
'PO WAOM IT MAY CONCERN:
I am requesting an extension of employment on
_ .�'
the Oshkosh Police Depattment till March 31, 1983.
Doctors remarks are attached.
Yoy�rs tru,�yy,,��
�d")'�W%C�� / !, � 1tL��
Donald Mand
Detective of Police
�
,
�
HA0.VEY MONOAY. M. D. �
OfHKO1M CLINIC BUILDING. IMC. ,
�00 CtAP6 AVfHU[
OSXKOSN. WIS. 86901
Oct. 23, 1981
To Whom It Iv,ay Concern:
I have examined Donald Nand
as of this date and find him to be
in good physical and mental health,
with no chronic ailments.
HN/bb
Sincerely,
/ V i'il.iC�1�.�:�•j.
! �/ �,
iI. bIonday, M.D.
�.
� o��� ����� ��.,.,��,
� l .� �uv, c,� �u.� � .
�j .Q�-''�`�h . �-C� : S S� �'d (
� .� ,z� �� ��--��,.C,�Fh�,
O/�2GQ� � �Z�(/Ll '�.L �YK�
��� « � ���.-�-��-�-�
�-� (/ � -�-(�'
� �.�'.�-�- �� �°
Q,�, � �( , / 4 �' /
� uy�--c.-._+�Q�t/+�t �y`^�_"_ �
�� �.��,�
��t ��(7�Q�Q .�,_ � rnta��cc a.0
&�.> i-�.� .��,-v`� .
�
'-U �
���.-e�0 �c�r� �,ro
�
Ezamicu[ion
THE MEDICAL EXAMINAiION REPORT
POLICE AND FIRE DEPARTMENT
(cl�v tide)
Dat /c/j�/�'�
i�
I.Name(Print) �`c������ �����<'����•C 2.Dateofbirt� �-,).`-,' ;.�. 3.Ag• ��
�. Sigaatute of �ppliciu
3. Heighc �1 C' � � � '' 6. Weigh� ��O . � �: .\ 7. Ches� �!5� — � .
VVi�bou< �boo SviDD�d O�diun elaLn EzD��ded Mobilit� Na�uN
& Eyesighc Sa<llin I'eer. Left 20/ �� L Right 20/...�.i�_ Borb 20/ '! �
Cortected to: Left 20%_U Right 20/ -�� Bo[h 20/ '� �'
Coloc tes�
9. Hearing: R ear �� L ru c�` � Discharge? �'� 30. Nos �� '
11. Deatal survey: Mark teech "O" if npped or pivo4 "S" if musiag; "X" if carious; "F' if false.
R 8 7 6 5 4 3 2 I 1 2 3 4 5 6 7 8 L PerErcc Caria stigh�
. Good repair v Caries markr�
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 Pyorr6r Need tleania6
12. Tons�i� � 13. Throa
14. Thyroi.i �'�'` �P I5. Sp« h ��
16. Lunga: Check for as�hma, mbenvimis, bmuchi�it, chett %-ny findiag �'"'`""'l
17. Heart: Cardio-vuculaz rystt �fd �`�� --
Pulse rat� 7S' Alood pressurr. Syaoli� ��P ��
Diutoli
18. Cnnro-incctinal cra�t: Check aPP�a� I � r_ '.
Chedc for guaic ulcer - "�
Gall bladder
19• Geaico-urinary: venereal diseasa Ku
VaticDCel• �zr
.. �____ %t•
Wasxtm
xrdr«ete /%^'��/ '�
Gene � /t�
20. He-^• `�M�' 21. Vuicose Vei � �"t'
(w�e form) - ��
22. Hand `�'L 23• Fm
fElat o� oNer mndidon)
24. Bona and join� �� 25• Spi��– ��'
26. Disabilicia: (chronic ncatrh, siaus, futula, recsal diseasn, cnssneous diseasc, eu.) `�u
27. Illnw and
28. Opcnao '" " -
29. Neuraic cmdrnci � �—
30. Could this msn perform duty involving beiag on hu feet for 12 houn concinuously7 y���'
31. Codd �his man pezform dury involving loag 6oun oF ducy iuvolving sittiag or ridiag? ��'�'�
I HEREBY CERTIFY THAT 2'HIS IS A TRUE RECORD OF THE MEDICAL EXAMINATION OF THE ABOVE EXAMII�EE
AND THAT I HAVE FOUND HIM �QUALIFIED ❑ p�SICALLY FOR THE DUTIES OF �-�� t- '" ��
QUALIFIED � �d..+ ud�) � , '
„"' ``–�-�Y/L � tu D.
MMid Ei.mins+
.
i0
MEDICAL HISTORY STATEMENT
(To be caken ia praence of examining physician.)
Do you belitve you �r< sound md well cow7 ! j�� Me you subjcct �o dizzinasl �1 �-' To uvve headachd � � L'
I
To pain iu the bre�sd �" r' To flutteriag of [he hetc[7 �U C' To ahor[noa of bm�67 �� ��'
To coughfl t��i
�� .� ���s
To diarrhea7_dS�l� To pila? ti� 1 To r6eumacism? �� L� H�ve you had sore eyes or any defea of vision? '' �'
�
I / // � � _,
Running from eithcr ear7 � U Is your smx of hearing good7�Have you had fia ot couwlsions? ��
i �
If so, how Frequrndy? n j A Uomnxioua spells? N� �� If so, how frcquendy? ����
As[hmd �� •ppendicicu7�f so, were you operaced upoo7�Ganotthnl �,\
�
When? A sore of any kind upon �our peais? Wheo?
Aay swdling abou[ oc of your [estides? �C n� A boil neac [he aous? (fistula)? ��� �-�
Have you beeu NPNfld� ��� Do you drink inmzicuing liquors co excas? 2���
If no[, �o wha�
ocher naccoucs? N�� �%r• Whec?
Wha[ wu �he cauu of your mo[her's death?
insanity, epilepry, or iaflammarory rheum.
�' (-�
Have you ever spi[ blood?
C
Do you use or have you used opium, morp6iae, coc�inq or aay
Wha[ was �he cause of your h[hei s deach? �Tl L
�
Hu any member of your family had [uberculosis,
Have you evet been hun upoa �he hnd? ^� �-'�
Aaswer fully �
/j� � � � � �1;-�.,�
Have you had a sprain? "��-? A stiff joind �° � A bone or joiat out of platt? ��' A bone broken?S_i �! -�.
J
Mhat bonn brokea? �c�: r r'. = v� �Ghrn?_�2._ V�. C�use? Are you subi�T �a
'/ '1
ptiaful corm or sore feed /� �'' Men�ion nrefully injuries or surgical operacions you may
hav< Lad upoa any aan of your body. upetially burns cuq xvere bnuse; or war wou
Whs� hospi�aliution have you had for U. 5. wu xrvice? � � � � � -�- �� C _ i �-S � � � � . �
Give name and addmf of physidan who lut att<nded yon, for wbat ailment, w�henl
I 6ereby cercify iha� the foregoiag stacemena ue crue to The bes� of my knowledge acd belief.
Signamre of Applican[
���«o.o �' ��<<, �?'lp
(sign full name)
,' ,•'• ���,,.�
_ ��J
Idovember 25, 1�81
hir. William Prueh & City Cour.cil
2 would like to extend my retirement with the
Oshkosh Fire Dept, from February 24, 1982 to February
24, 19a3. A.physical fitness £ecommendata:on w'r11 be
forthcoming.
Robert F. Hable
Equipment Operator
`�U�✓� � l�`�
.
RICHARD D. ADELMAN, M. D.
400CEAPF„AVENUE — OSI�KO$Fj, WISCONSIN 56901
R For
1�
� (q ��� '� �
P
� ���
��
.,
NON REP. ['j � ' - � � .
REFILL TIMES � � .
This prncriprion can be filled af .
MUELtER-0OTTER DRUG STORES �
.� IO�h 8 Oregon S�s. — 400 Ceape Ave . � �• -
210 N. Main Sc — 717 N. Sawyer Sf. . � .
�
��
� v�
� ��
•�+ a
+� v
vn
�� x
.. v
;�i b �,
'� � N G.
v<
+�
.�'= SC �t3
., W
v
o u
+� •�
�
C o
O W
.�
1J I
�
� �
O N
Vl J-�
v �
LY+ 1-a
�
N
m
A
4
+�
o �d
b v
¢ •�+
z.
o H
H �
U
�+
O
.�
J-�
�
�
r-,
�
�
� �
^ c�
� x
u
u v
v �
a�, 'l��y
� 4- �
q U