FormNVDH Form 200 request for chest X-ray, new employee Jack Coffelt3 December 19711 page
fbi_formLegibility: medium

Part 86, page 67

DB Cooper-37911

Document date 3 December 1971

Open in FBI Vault (Part 86, page 67 of the PDF)

FBI 164-81, Vault Part 86 p. 67 (DB Cooper-37911), Form, dated 3 Dec 1971 — cooper.theunsolved.net/parts/Cooper-Part-86/pages/67

Transcript

The scan is the source; the transcript is machine-generated from it.

#9

REQUEST FOR CHEST X-RAY

Employee's Name COFFLET, JACK Date of Request 12/3/71

Date of Last Chest X-Ray ________ New Employee X

Annual Follow-up ________

Semi-Annual Follow-up ________

Please send copy of report to the Personnel Office to be filed in employee's personnel folder.

b6 b7C

NVDH F#200 Personnel Office

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DB Cooper-37911