HomeMy WebLinkAbout29120 / 77-13September 15, 1977
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Wi�2EAS, ttie City of Oshkosh on the 21st day of March, 1974, adapted an
Ltn.ifozm Extensic� Policy for employ�s of the polioe and fire d�partinents,
and
WHEREA.S, the follcx,�r�ng police personnel hav� met the requ.irements of said
L?niform �tensia-� policy and have requested a one-year extension of their
er.�ployment:
RIC�L�.�2U PHILLIPP�,�- 4th �quest - Police Depart�nent
Date of Birth: Nove-�nber 2, 1919
Original Retiren�nt Date Was Pecez�er 31, 1974
Ea�loyr�nt Extension Through Dece.mber 31, 1978
RJI3F�' EOFiEEN - 4th Request - Polic� I�pa.rtir�nt
Date of Birth: Novemb�r 15, 1919
Original Retirement Date Was: December 31, 1974
�lo��nent Extension Through: Deaerr�aer 31, 1978
ROBERT NIC.�IOLL -- 3rd Rec1uest - Po1ic� Departrnent
L�ate of Birth: October 29, 192Q
r'•r'3.y1Tlc"1Z P.c''"�.2�e.«;�t Da� IfCl."7: iA�C�iiu�Jt�-�'Y' Jlt �GiJ
II�ploym�nt Extension Through: �ecember 31, 1978
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City
of Oshkosh that the foregoing extensions are hereby granted.
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� TH� h�ED�C�iL EXAII�INAilO�J �EPO�T
POLICE AND FIRE DEPARTMENT
Examinauon fot '/�'% � y� l�~ �ti Date �` t�( ' 7
(class ticle)
1. Name ( print )��'�[ G� a Y � �/� t lt� t�'� 2. Date of birth j�'�- ' 1 �I 3. Age `� ?
4. Signaritre of applicant `:��-! r"'r�� :...,�> r`%%�c..=`! �"> -�
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5. Heighr ` 6.
Wichout shoes
8. Eyesight: Snellin Test:
��- -
Weighc ,�__ � "-' 7. Chest L/ '7 , `� /;
Stripped � Ord;nary cloches Espanded • Mobiliry Natural
Left 20/ 'S 1-�' Right 20/ � E� Both 20/ ���
Corrected to: Left 20/ ,? � Right 20/ h-� Both 20/ '�' '
Color tas� _ �`fj j'�'p, �_{ .
9. Hearing: R ear �J � L. eat �% � Discharge? �'-%� 10. Nose ��
11. Dental survey: Mark teeth "O" if capped or pivot; "I" if missing; "X" if carious; "F" if false.
R 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 L Perfecc Cazies slight
Good repair- � Caries mark�
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 Pyorrh� Need cleaning
12. Tonsilc ���,+., iT� � 13. Throar- � Ct
14. Thyroid :�% n:. a..� l 15. Speech � GE
16. Lungs: Check for asthma, tuberculosis, bronchitis, chest X-ray findingc (JlPn �
17. Heart: Cardio-vascular syste�r+ 1_1i d y c�.. c�
Pulse ratP � � Blood pressure: Systolir �`{ � Diastolic ? G
18. C�astro-intestinal uact: Check append�x 4�
Check for gastric ulcer � Liver �-�
r�t� irt�aa�_ 62e., ,
19. Genito-urinary: venereal disease /U �J Wasserman. -
VazicocelP � Hydrocele "��
iiidneyc ��
20. Hernia �-n 21. Varicose Veins � c
(noce form)
22. Hands D LC 23. Feet l l.
� (flat or other condition)
24. Bones and jointa �t 25. Spine l� Lt
26. Disabilities: (chronic catarrh, sinus, fistula, reaal diseases, cutaneous diseases, etc.)
27. Illness and
28. Operationc _ k/ � � �
29. Neurotic tendencie� �> h .. �
30. Could this man perform duty involving being on his feet for 12 hours continuously?� ��r-�
31. Could this man petform duty involving long hours of duty involving sitting or riding? �-t�
32. Remark�
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I.HEREBY CERTIFY THAT THIS IS A TRUE RECORD OF THE MEDICAL EXAMINATION OF THE ABt3VE EXAMINEE
AND THAT I HAVE FOITND HIM �QUALIFIED ❑ pIiI,SICALLY FOR THE DUTIES OF ��� �j'a It.� u•-�
QUALIFIED �
(ciazs tide)
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Medical Ezaminer
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NIEDlCAL HISTORY STATEi�E�fT
(To be taken in presence of examining physician.)
Do you believe you are sound and well naw?�'P..tL Are you subject to dizziness?�To severe headache? �l��
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To pain ia the breast? " r� To fluttering of the heart? �� To shottness of breath? ��'�-a To coughs? "T ��
To diarrhea2��, a To piles? �+'� To rheumatism?� Have you had sote eyes or any defect of visioa? �� �''��P�
n S I a,rt�
Running from either ear? � it-r. Is your sense of hearing good?� Have you had fits or convulsions?� ?2 wP.4,�
If so, how frequently? Unconscious spells? �� If so, how frequently?
Asthma? �� �,ppendieitis? �' N� if so, were you operated upon? Gonorrhea?
When? A sore of any kind upon your penis? �✓' �1 When?
Any swelling about or of your testicles? �-U A boil near the anus? (fistula)? ��%i+
Have you been ruptured? �-%, Do you drink intoxicating liquors to excess? ✓�--� �
If not, to what extent? Do you use or have you used opium, morphine, cocaine, or any
other narcotics? �� Whea? What was the cause of your father's death? n p—�'�
What was the cause of your mother's death? `�.c> � 1� vnn� �..� , Has aay member of your family had tuberculosis,
insanity, epilepsy, or inRammatory rheumatism? ��-,
Have you ever spit blood?- v�� , Have you ever been hun upon the head? "/� U
Answer fully
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Have you had a sprain?����- A stif� joint? %Y',-�t� A bone or joint out of place? ��" A bone broken? �`v
What bones broken? When? Cause? Are you subject to
painful corns ot sore feet? `'R' 1��'ention carefully injuries or surgical operations you may
have had upon any part of your body, especially burns, cuts, severe bruises, or war w•ounds � n- «�-��
What hospitalization have you had for U. S. war service? `'�n �M
Give name and address of physiciaa who last attended you, for what ailment, when? � m. �
I hereby certify that the foregoing statements are true to the best of my knowledge and belief.
Sigaarure of Applicant
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(sign full name)
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August 23 1977
To I�Zembers Of The Oshkosh Common Council
I Respectfully Request �a One Year Extension As An
Active Niember Of The Oshkosh Police Dept. I�'lould Appreciate
if I Could Get a One Year Extension From January l, 19?8
Until Decernber 31� 1978a
Attached is a Certificate From a Licened Physiciana
Sincerel js yours,
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JULY 28,19'%7
TO: HONOFiABLE 1"�MBEFIS, OSHKOSH CITY COUDTCIL
FRON: OFFICER ROBEAT J. NIC�iOLL
SUBJECT: EXTEI�TSIOId OF ACTIVE DUTY WITH POLICE DEPT.
Honorable Council Me�bers;
On July 26� 1977 The undersigned Officer, a
Veteran of T�c�renty-Three years of service with the Oshkosh
Police Department� underwent a thorough physical examination
adlainistered by Doctor Ben S. Greenwood, and the results of
that exa.minatior_ are herein enclosed.
The undersigned was determined to be in excellent
physical condition, except for being a bit overweight.
As the above does not present any hinderence to
the ability of the undersigned in the perform,�nce of his job,
I therefore respectfully request consideration of a one year
extension of duty, a5 per regulations governing the extension
of emplaymer�t of Police OfFicers, beyond the age of fifty-five
years.
approval;
T rusting the above will meet with your favorable
I remain;
I�espectful yours
ur�d . � t f'���
�fficer: Rober J. Nicholl
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TE�_EPHONE 231-6800 BNDD No. AB3875125
DEAN B. SECKER. JR.. M. D.
400 GEAPE AVENUE OSHKOSH, WISCONSIN
NAME AGE
AODRE55 DATE " ` �� `� �
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DEPARTMENT OF POLICE
June 7, 1977
Oshkosh Common Council
City Hall
Oshkosl� Wisconsin
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��� POUCE
I would like to submit a request to the City of Oshkosh
that I be granted an extension, so I may continue working
for the Cit�r of Oshkosh.
Nov. 15, 1977, I will be 58 years oid, I have had a complete
physical from Dr. Becker and he has found no problem with
my health.
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Robert 0. Boheen
Capt. of Police
C!?'' F'•,4'.l. A 215 CHURC.H AVENUE e P. O. BOX 1130 • OSHKOSH, WISCONSIN 54901
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