Get DA 1058-R 2010
NK 31. UIC 32. HIV TEST DATE 33. PANOGRAPHIC DENTAL X-RAY ON FILE YES NO 34. List all previous AD, TTAD, AT, ADT, IADT, and ADSW in the previous and current fiscal year showing inclusive dates, purpose of tours, and HQ or agency to which attached. a. PERIOD OF TRAINING/DUTY FROM TO NO. DAYS b. TYPE TRAINING/ DUTY (AD, TTAD, etc.) c. LOCATION/ INSTALLATION e. SIGNATURE OF UNIT COMMANDER f. DATE 35a. NAME OF RECORDS CUSTODIAN ( Last, First, MI) b. GRADE c. SIGNATURE d. DUTY PERFORME.
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