Hepatitis (dates of diagnosis and cure) within 6 months; liver function studies.
Hernia surgery (date of operation).
Stomach ulcer (copy of X-ray report), pyloric stenosis (operative narrative).
Deformity or loss extremity finger(s) or toe(s) to include photographs.
Foot trouble.
Back trouble.
Hearing problem, wearing of hearing aid.
Ear surgery, except lancing on eardrums if in childhood only (operative report).
Surgery of abdomen, except appendectomy (operative report).
Bone or joint surgery (may require consultation regardless of documentation).
Painful or "trick" joint (shoulder, elbow, hip, or knee).
Surgery on female organs.
Absence or interruption of menses.
Brain surgery.
Tumor surgery (except skin cysts and tumors of the skin)
Heart or chest surgery.
Rheumatic fever.
Organic valvular heart disease.
Dyslexia, any history of (learning disability).
Allergies to bee stings.
Hayfever requiring frequent treatment; or allergy desensitization.
Illness or injury which required repeated treatment by a physician or surgeon, hospitalization over 30 days, or a surgical operation.
Skull prothesis (plate).
Albuminuria (protein/albumin in urine).
Healed fractures with plates, screws, pins, rods, or other orthopedic devices in place.
Enuresis (bed-wetting).
Somnambulism (sleep walking).
Acne, Grade III, pustular and/or draining.
Pseudofolliculitis Barbae (PFB) (ingrown hairs on face).
Hodgkins disease (lymph node enlargement).