| Document Date: 2009-11-17 14:00:36
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City Warsaw / / Facility Wyoming County Community Hospital / / MedicalCondition pain / back injury / Seizures (fits) Diabetes / indigestion / Allergic reactions / Chest pain / seizures / blind Yes No Injury / Eye irritation Yes No Skin allergies / Asbestosis Chronic bronchitis Lung cancer Tuberculosis Chest injury/surgery Pneumothorax / Shortness of breath / Kidney problems Liver problems Yes Yes Yes Yes No No No No Allergic reactions / sugar disease / Coughing / Wheezing / Claustrophobia / / MedicalTreatment surgery / immunizations / / Organization Wyoming County Community Hospital / Workplace Health Service / / Person Job Duties / / / Position Physician / Prime Minister / / ProvinceOrState New York / /
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Microsoft Word - RespexamOSHA1910 134 WPH Survey