DATE
MEDICAL FITNESS STATEMENT
FOR ENROLLMENT IN BASIC COURSE, SENIOR ROTC
For use of this form, see AR 145-1; the proponent agency is ODSCPER
I have examined
and find no medical
(First Name - Middle Initial - Last Name)
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.
SIGNATURE OF PHYSICIAN
DA FORM 3425-R, 1 SEP 68
USAPPC V1.00