DATE
SIGNATURE OF PHYSICIAN
condition or physical impairment that precludes his participation in the basic course, Army ROTC, a
program not more physically strenuous than a normal college physical education program.
For use of this form, see AR 145-1; the proponent agency is ODSCPER
MEDICAL FITNESS STATEMENT
FOR ENROLLMENT IN BASIC COURSE, SENIOR ROTC
(First Name - Middle Initial - Last Name)
DA FORM 3425-R, 1 SEP 1968
APD LC v2.00ES
I have examined and find no medical
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