14 



Examined Case No. 



at 



Name Sex 



Occupation Age 



Usual Place of Sesidence 



Places of Kesidence abroad, with dates 



Previous attacks of Dysentery Where ? When ? 



Persistent Diarrhciea V 

 Liver Abscess ? 



PK0T0Z00L0L4ICAL EXAMINATIONS OF STOOLS. 

 Dates I Findings. 



Remai'Ks 



