15. NAME AND ADDRESS OF EMERGENCY ADDRESSEE
Joyce Fulgham (W)
5540 Gross Drive Dayton Ohio
16. AGE
31
17. RACE
Cau
18. LENGTH OF SERVICE
12 yrs
19. DATE OF ADMISSION
12 May 59
20. SOURCE OF ADMISSION
From duty
21. ADMITTING OFFICER
L. E. Eason Capt USAF MC
22. CONTINUATION OF ITEMS 12 AND 20.
(a) AFB, Ohio
23. DIAGNOSES
8715 Hematoma, traumatic, n.e.c. forehead LD: Pending AF Form 348
AI: Approximately 0600 hours, 21 May 1959, North of Roswell,
New Mexico, patient states he was taking part in a military
project involving balloon testing. When he and two others
landed in the balloon the “gondola” upset, and hit him in
the head causing injury.
24. OPERATIONS AND SPECIAL THERAPEUTIC PROCEDURES
None