Further things of interest here:
A Casualty Report is issued by the paper pushers back at Saigon, far from the action, to try to let other paper pushers back at CINPACFLT, BUPERS, BUMED, etc., have some idea what's going on. (More or less.) However, it is a second hand information summary unlike the actual medical record entry made by a medical officer or by a Corpsman.
A real life Casualty Report based on the now famous "Frank Burns Gets a Purple Heart" MASH episode would indicate that Frank was recovering from a "shell fragment injury" and that he was "treated by a medical officer". The actual medical record entry by CAPT B.F. Pierce, MC, USA would indicate that the injury was an eggshell fragment in the eye as a result of making an ommlette in a war zone.
Why put a copy of a second hand summary (that can often get the details wrong) on the Internet instead of putting a copy of the actual medical record entry to see the exact nature of the injuries?
The Purple Heart requirements specify that the award is reserved injuries that "require treatment by a medical officer".
The two Casualty Reports (the other one, if it ever existed, is missing) indicate that Kerry sought treatment aboard Coast Guard cutters: USCGC Spencer (WHEC-36) and USCGC Wachsetts (WHEC-44).
One Casualty Report states that Kerry was treated by a "medical officer". Did Coast Guard cutters in Vietnam actually have "medical officers" aboard? There is no Coast Guard Medical Corps.
The other Casualty Report mentions "treated by MD aboard USCGC Wachusetts". Never, in my Navy Medical Corps career, was I ever referred to as an "MD" in official communications. All M.D.'s were referred to as "medical officers". Does the "MD" in the Casualty Report actually refer to the "Medical Department" aboard the Coast Guard Cutter Wasuchetts?
Even if Kerry did see a "medical officer" that does not mean his injuries "required treatment by a medical officer". As the medical officer aboard a Navy nuclear powered cruiser, I saw my full share of "boos boos" and sore throats at Sick Call right along with my Corpsmen.
Just because you are seen by a medical officer at Sick Call does not mean the blister on your little toe "required" treatment by a medical officer. A minor injury could be treated at Sick Call by anyone from a Lieutenant Commander in the Navy Medical Corps to a nineteen year-old Third Class Navy Corpsman. It all depended on how busy and/or how bored the medical officer was that day during Sick Call.
Only the posting of the actual medical record entries on the Internet can answer these questions.
Anything else, as is the case of the Casualty Reports, is only second hand hearsay.......
Which may be exactly why Kerry decided to post two Casualty Reports instead of the actual medical record entries to explain how he got "earned" (or not) three Purple Hearts.