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HomeMy WebLinkAbout29120 / 77-13September 15, 1977 • -,• �. �► � u - - � i� � • . �� : • • � �� � �� • •� i� � # 13 �sor.�rzoN 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. _ �3 � �,,. �m� . ! � 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..=`! �"> -� �� � � �� 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� � rrr,� 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) _ / %.� � P.r �l.P./_�Ci�� 1bT. D. Medical Ezaminer .n� �r � �]^� ��s'i}"i!.%�a Q. �}1�`�.''9: ? . �� ��, "_�. �5ci f1Q%;"r�,�2� ,'�a�i^?' QaiJ;i��ti, � r �: �: 1sYl�. ..-,r,:i: , � 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�� /� � ✓ 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 �v � �� 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 � i (sign full name) r i 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, . l.%�`�-z.�c`���� � ��� • �� � _,a / , I t` ��� , 5� /vl�`Il.zv �c�CE.Y'� � 1 �i(y 61 ! � �� ���� .a7� ��f�: 'L%��'. ��� ��� , �9 ' �-�.c � I 7� � � rn �-l.S � O J 2r �c. t��..L ��(s Pt,. S�c�� b,:t � �%Si�-- Ok��t�us�s � �e.q.rr� - G�lG r�d. t��•� �zz�... O �-. - � , (:.01 �r J t��� C� � � .�`'�� � G <� �� ��� �� � � ►�.o � ed � ��.�.� �., �� � � ��� �� �_��..Q. O.ro �-e. T� C�.Y r Ov\. � �� � �t � � � � �a��c� 0���� d �'�.I e.S , , ��-�=� 4� �.� , � _ _ iC�c—<-�--C-C�-�'- ' __ I I � �C ,.1 �1 �L� I y � 7 � � � �' � � �� Y�� - � M � 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 Y � � j TE�_EPHONE 231-6800 BNDD No. AB3875125 DEAN B. SECKER. JR.. M. D. 400 GEAPE AVENUE OSHKOSH, WISCONSIN NAME AGE AODRE55 DATE " ` �� `� � • /� � l.��f- ✓4Cj.L,� y/'�: [-ij"�[r�'���f ...C/ Z-rJ_�r� C-Li-C�'-%i l � r ,, -f� � j , � �� �i�c�L% ? % G%-iGr'�'�� ! �:-LLG� � F' �� f / ��.�.C- ���/r—t�i�-!`- ��! � � � ,� �, �. ; � � r /l /�� '' .%``�'�--��`'�"✓��%.'-'` . ,� � f� � _ �f � � ... � , m ctsr� � �., oi�',..:. °osKK�x� xw,�- , . DEPARTMENT OF POLICE June 7, 1977 Oshkosh Common Council City Hall Oshkosl� Wisconsin couNCi�-�.a�;�;;.�_,_t� n,,,:��,,.��r , , �,��; �' `� �0 ' � ,1�Y i �.c� nq� ��� 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. � ��� �''��c-1��C% U� c''�-u�---- Robert 0. Boheen Capt. of Police C!?'' F'•,4'.l. A 215 CHURC.H AVENUE e P. O. BOX 1130 • OSHKOSH, WISCONSIN 54901 ,-. � ... � N � � � ,� O � � •ri Q � O � H � U � O � � O � ,�.M��___._ __---._._. i �,,il1��o.C1��_ ti ti rn ri ;�. :� Lf� r-1 N N � N � � � � N •ri � U