| OCR Text |
Show l\farr-ied or Single Age Location j1 N 1Jr/ 1)1_/ j ?Ju 1J1/ :JI: JJt, u.Af7 /}'/ M 111/ )n )J1. A4. ?Ju Ml ?Ju ?u./ ;;-z_..------- C r:u /;J 37 j-{, J.J 21 JcS-, .2 g 1 0 II /~ II :J ;J JJ.(J l ( //~ ?1 J, {p /( /~o rt 11/L ( I ' ?>v,, Cf; ti II ?J1/ l3cl; . + :38 I (!_, tr 1,l.«~ . ff /#1/~£ " /;;Ja.-/~ I I I 7 t; I I I( // /3 / OF l1TJ • 1~~-. l( ,, .:7 u :}-- 3~ Lf-g ;1-b 1/~SJ. r6 /~ (a /() y I , /~Y 3 :J- I >--3 /~ r/ l/ .I7 (!__.I IC, Jr, ,' rr fl II I r / I ,, ft C,.(. If (I ( I I I l'6 I' Ir !feAJ I 6-tJ aL:?'~k ~a,,L,) I• I( tl .Js- ., /1 f I rrv Diagnosis /( '~ '2,--/ "M/ J-'1 }x_. 2J-, ,,, ' ?'n-- Discharged or Died Id '-·7/N 111/ Physician t',1 // I/ ff~- - Remarks |