DO NOT MAKE ANY MARKS ON THIS BOOKLET
1. Hike mechanics magerines.
2.1 havo a good appetite.
1 wake up fresh and rested most mornings.
|. 1 think I would like the work of « librarian.
5.1 am easily awakened by noise.
6. I liko to read newspaper articles on crime,
7. My hands and feet are usually warm enough,
8. My daily life is full of things that keep me in-
terested.
9. am about as able to work as I ever was,
10. There seems to be a limp in my throat much of
the time,
11. A person should try to understand his dreams
and be guided by or take warning trom them.
12. I enjoy detective or mystery stories,
13. I work under a great deal of tension.
14. I have diarrhea once « month or more.
15. Once in a while I think of things too bad to talk
about.
16. 1 am sure I_get a raw deal from life.
17. My father was a good man.
18, Lam very seldom troubled by constipation.
19. When I take a new job, Hike to be tipped olf on
who should be gotten next to
20, My sex tile is
putisfuctory.
At times 1 have very much wanted to leave
home.
2, AL times [have fits of lnughing and crying that
1 cannot control.
23, Lam troubled by attacks of uausea and vomiting
24, No one aoems to understand me.
28,
26.
27,
28.
30.
al.
92,
33
34,
38.
36.
37.
38.
99.
40.
al
1 would like to be «
ger.
J feel that it is certainly bes! to keep my mouth
shut when I'm in trouble.
Evil spirits possess mo at times.
When someone doos me a wrong I feel I should
pay him back if I can, just for the principle of
the thing.
|. Lam bothered by acid stomach several timos a
week.
At times I feel like swearing.
I have nightmares every few nights.
I find it hard to keep my mind on a task or job.
Ihave had very peculiar and strange experi
ences.
I have a cough most of the time.
If people had not had it in for me I would have
been much more successful.
I seldom worry about my health.
I have never been in trouble because of my sex
behavior.
During one period,when I was a youngster |
engaged in petty thievery.
At times I fool like.smashing things
Most any time I would rather
than to do anything else.
and daydrean
Ihave hud periods of days, weeks, or month
when I couldn't take caro of things because
couldn't “get going.”
My family does not like the work I have choses
(or the work L intend to choose for my lite work
My sleep is fitful and disturbed
Much of the time my head seems to hurt «
ove
Ido not always tell the truth,
GO ON TO THE NEXT PAGcea age A) ST sols
wl
vent ols 3
ete lel at eee sateen ieee tient iapeee
olga. ve ae GMT sila ie wr
For Official use only
fee ee eee ceed g cag ecco ted
2 eee cee aed aereray eee nee Pa Pe Sc Ma SI
fan Score 2. B. IS 1B 22 2% WA 26 3H th. AY 30 al. Bar
K to be added i} Di i. B. 2.
Paw Score with K 32. 3h 31. 42. Al
Tseere (Corrected) =. “BR ST. HO BG. G1. BB HS 9B 53 BA 59 56 49
T Scare (Uncorrected) 22 6S. Bor ode oa
Pe ene Se) Se Oa ace
hy shen 1 Semedoform ¢ CONVENSION.
mission, Copyright 1943, renewed 1970 by the Universiey of Minnesota.
si Corporation, Hew York, N.Y., U.S.A All rights reserved,
tema: Symptoms nypocrerdnasis one!
Depot 13/3!
B) PSOHO-AE Teaned a taped
Pobilhed by che Pchel
Lahore, Pakisten