It is dated October 8th 1886.

" Increase Pension Claim No. 197328, John Fitzgerald, Rank Private Company B, 12th Reg't Mo. Cav., living at 2839 Almendo St., Philadelphia. We hereby certify that in compliance with the requirements of the law, we have carefully examined this applicant, who states that he is suffering from the following disability, incurred in the service, viz: Rheumatism, and that he receives a pension of 24 dollars per month.

Pulse rate per minute 72; respiration, 18; temperature, normal; height 5 feet 5 1/2 inches; weight 130 pounds; age, 50 years. He makes the following statement upon which he bases his claim for increase of pension under the act of Congress Aug. 4th 1886. Upon examination we find the following objective conditions: a fairly nourished man (on crutches). Heart irritable and sounds somewhat accentuate. No bruits. Lungs normal. Has complete anchylosis of right knee and dislocation of the head of tibia posteriorly causing a marked deformity known as 'knock knee' and about 4 1/2 inches shortening of leg and even some of foot and elevation of heel and stiffness of ankle joint with marked atrophy of entire limb. Also lateral curvature of spine. Has a puckered and adherent scar to femur about the middle of right thigh. Made no doubt to remove necrosed bone. Motions of right hip found somewhat limited. Alleges rheumatic pains in various parts of body, especially in left hip joint, which appears painful on motion. Has total disability of right knee and thigh and the entire limb. No signs of syphilis.

From the existing condition and the history of this claimant, as stated by himself, it is our judgment that the disability was incurred in the service as he claims, and that it has not been prolonged or aggravated by vicious habits. He is, in our opinion, entitled to a total second grade rating for the disability caused by Rheumatism deformity right leg."