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U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
FILED PURSUANT TO SECTION 16(a) OF THE SECURITIES EXCHANGE ACT OF 1934,
SECTION 17(a) OF THE PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 OR SECTION
30(1) OF THE INVESTMENT COMPANY ACT OF 1940
FORM 4
[ ] CHECK THIS BOX IF NO LONGER SUBJECT TO SECTION 16. FORM 4 OR FORM 5
OBLIGATIONS MAY CONTINUE. SEE INSTRUCTION 1(b).
OMB APPROVAL
OMB Number 3235-0287
Expires: February 1, 1994
Estimated average burden
hours per response........0.5
1. Name and Address of Reporting Person
MICHAEL JOHN H.
(Last) (First) (Middle)
1810 24TH STREET, N.W.
(Street)
WASHINGTON D.C. 20008
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol (PERS)
PERSONAL DIAGNOSTICS, INCORPORATED
3. IRS or Social Security Number of Reporting Person (Voluntary)
###-##-####
4. Statement for Month/Year
September 1997
5. If Amendment, Date of Original (Month/Year)
N/A
6. Relationship of Reporting Person to Issuer
(Check all applicable)
[x] Director [X] 10% Owner
[x] Officer (give [ ] Other (specify
title below) below)
CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER
Table 1 -- Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
<TABLE>
<CAPTION>
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1. Title of 2. Transaction 3. Transaction 4. Securities Acquired (A) 5. Amount of
Security Date Code or Disposed of (D) Securities
(Instr. 3) (Instr. 8) (Instr. 3, 4, and 5) Beneficially
(Month/ Owned at
Day/ End of Month
Year) (Instr. 3 and 4)
Code V Amount (A) or Price
(D)
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<S> <C> <C> <C> <C> <C> <C>
COMMON STOCK 9/9/97 P 20,000 A $1.03
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COMMON STOCK 9/11/97 P 10,000 A $1.06
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COMMON STOCK 9/17/97 P 4,300 A $1.06
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COMMON STOCK 9/22/97 P 10,000 A $1.03 3,678,432
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</TABLE>
<TABLE>
<CAPTION>
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1. Title of 6. Ownership 7. Nature of
Security Form: In-
(Instr. 3) Direct (D) direct Bene-
or Indirect ficial
(I) Owner-
(Instr. 4) ship
(Instr. 4)
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<S> <C> <C>
COMMON STOCK
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COMMON STOCK
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COMMON STOCK
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COMMON STOCK
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(over)
(Print or Type Responses) SFC 1474 (3/91)
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FORM 4 (CONTINUED)
TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
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<S> <C> <C> <C> <C>
1. Title of Derivative Security 2. Conversion or 3. Transaction 4. Transaction Code 5. Number of
(Instr. 3) Exercise Price Date (Instr. 8) Derivative
of Derivative (Month/ Securities
Security Day/ Acquired (A or
Year) Disposed of (D)
(Instr. 3, 4,
and 5)
Code V (A) (D)
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</TABLE>
<TABLE>
<CAPTION>
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<S> <C> <C> <C>
1. Title of Derivative Security 6. Date Exercisable and 7. Title and Amount of 8. Price of
(Instr. 3) Expiration Date Underlying Securities Derivative
(Month/Day/Year) (Instr. 3 and 4) Security
(Instr. 5)
Amount or
Date Expiration Title Number of
Exercisable Date Shares
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</TABLE>
<TABLE>
<CAPTION>
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1. Title of Derivative Security 9. Number of Derivative 10. Ownership 11. Nature of
(Instr. 3) Securities Beneficially Form of Indirect
Owned at End of Derivative Beneficial
Month Security: Ownership
(Instr. 4) Direct (D) (Instr. 4)
or Indirect (I)
(Instr. 4)
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<S> <C> <C> <C>
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</TABLE>
EXPLANATION OF RESPONSES:
/s/ John H. Michael 10/08/97
**SIGNATURE OF REPORTING PERSON DATE
**INTENTIONAL MISSTATEMENTS
OR OMISSIONS OF FACTS
CONSTITUTE FEDERAL CRIMINAL
VIOLATIONS.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
NOTE: FILE THREE COPIES OF THIS FORM, ONE OF WHICH MUST BE MANUALLY SIGNED. IF
SPACED PROVIDED IS INSUFFICIENT, SEE INSTRUCTION 6 FOR PROCEDURE.
