HomeMy WebLinkAbout31096 / 80-12De�irber 18, 1980 � 12 F�'SOLITPIQV
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WHE'-'i�r:FS, tne City o£ Oshkc�h, cn the 6�h 3ay of I��r,.'^,er, 1479, zd�t,.r3 a
Uniform E�nsion Policy for enployees of the police and fire departirents; and
wf�, the follaaing police departrcent and fire depari�rent personnel ha�e
�t the �ecluirenents of said Uniform Extension Policy and hac� requested a one-
year extension of their e[cQloy�nt:
DQ�IAI.D MAND - 2nd Rec�iest - Police Il�par�nt
Date of Birth: March 24, 1925
Orimn�� Retise�rent Dat� was: March 31, 1980
Enplo�ment Extension Throuc�: March 31, 1982
C�RAI.D SCHLFSISKE - Sth Request - Fire Deparnrent
Date of Birth: Februaxy 25, 1922
Original Retsrn�nt Date S�as: L+arch 31, 1977
ERQloyn�nt Extension Through: March 31, 1982
�SEITi' iil-�ELc^. - iot R��st - Fir� i,'�--�"�-tr:�:i�
DatQ of Birth: Febxvary 24, 1926
Oriqinal Fetirenent Datz Was: Mazrh 31, 1981
Enploynent Extsnsion Through: March 31, 1982
NOw, Tf�REEORE, BE TT i�SOLVID by the Co�on Cotmcil of the City of Oshkosh
that the foregoing extensions are hexeby granted.
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Dlovember 13, 1980
Mr. William Frueh
Members of Oshkosh City Council
City Hall
Oshkosh, Wi 54901
Dear Mr. Frueh and Members of the City Council,
I hereby request an extension of employment taith the Oshkosh
Fire Department beyond my.normal re±irement date of February
zu, i9ai.
Attached please find a statement from Dr. Adelman dated November
11, 1980.
Respectfully,
(�""1 �
Robert Hable •
Equipment Operator
Oshkosh Fire Department
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THE MEDICAL EXAMINATION REPORT � (�
POLICE AND FIRE DEPARTMENi'
Essmi�[ioo for CI . 1'� /��. ��f'�M�I✓l Dan 00 �• �'% >�Gty��
(cl�u aitle)
I. Name (Prin[) ��� �� ���e'� � k-� 2. Date of bir[�+ a' �•5 ' a°� 3. AB�
�{. Signsture of aPPlicane � ,
S. Heighr / V /1 6. Weighr oco� v 7. C6esr T� .
Wia6ouc �hon SviDMd � Ocdinv� doaha � /� i�vvodcd Mobi6q
8. Eyaighr. Snellin Tat: LeFt 20/ 4!U RiBht 20/��v Both 20/� D
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Coiiecced to: Leh 20/�, Right 20/s��! Both 20/�
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Color cese i�cs-.-.f. �
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9. Hearing: R eaz �1( L. ear ��/ Disc6acge? �/cF��� . 30. Nos f��' �
11. Dental �urvey: Mark tee�h "O" if capped or pivo[; "I" if missiag; "X" if carious; "F" if false.
R 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 S L Perf Carin slighr
Gaod repau �" � Cazies marked
8 7 6 S 4 3 2 1 1 2 3 4 5 6 7 8 Pyorrhro Need deaniag
12. %ns��� ` 13. T'hrosr ��`
14. Thyroi.l ��� 15. Sp ��� �
16. Lmgs: Check fot asthma, tubercvlosi bmachi ' chat X-ny fiadine ��6f `"��
17. Heazt: Cardio-vazcvlaz rvs[ �"'�
Pulce nv �/ '� Alood pressure: Syrtn
18. Crastro-iatesciaal crac[: Check appeadir ��'�'� c-
C6eck foc gastric ulcer ``:` s=ir c
Gdll bladder � ` � �'f�
19. Genito-urinary: venereal disesse c' {���c -
Vazicoccl `![tic �.
liva �`�- '
Wasserm �- �
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Hydrocel , "����•� ``�� ``.•✓
20. Hetuis F��'rG 21. Varicose Vei�< `y ��{,
(oom form) f�
i� Lf
22. Hand� 23. Feer
(fla� oe aLer mndiuoa)
24. Bones and joinn ��� 25. Spin ��L '
26. Disabilities: (chronic rarurh, sinus, Fistula, rettal diseases, cutaneous diseases, ett.)
?cs���
27. Illness and iajuries � �-Zce>rc.-
28. Opentioa �.�.��-i�/�����t-- �yi
29. Neuro[ic teadeau ""O�`� �
30. Could chi� man perform'du[y iavolviug beiag oa his fee[ fot 12 houn contiauously7 �'�
31. Coald this man pedocm dury involving long hoan of dury involving si[tiag or ciding? ���
I HFREBY CERTIFY THAT THIS IS A TRUE RECORD OF THE MEDICAL EXAMINAT'ION OF THE ABOVE EXAMINEE
AND THAT I HAVH FOLJND HIM �QUA�� � PHISIGALLY FOE THE DUTIES OF �r �'°� �`�^�" �
QUALIFIED � (dm ria�e) -,
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Med:d Eicm:net
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October 2y, 1980
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Mr. Norbert Svatos
215 Church Ave.
Oshkosh, WI. 5�+901
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Dear Sir:
I am requesting an extension of employment on the
Oshkosh Police Department until March 31, 1982•
The doctors remarks are attached.
Yours truly,
�"� � .c�LC ��� �'(
Donald Mand
Aetective of Police
:YAqvflr MoNOwr, M. D.
MXRO�M CI.INIC BUILOtNG. INC.
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October 24, 1980
To Whom It May Concern;
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I have examined Donald Aland this date
and find him to be in good physical
and mental health, capable of perform-
ing his duties as a police officer.
Sinc�erely,
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H.htonday, M.D. `��
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