I don't think I've ever seen a '76 PHS doc, but sometimes when the copy isn't so good, it helps to compare it to a clearer copy.
The codes on my '64 Fremont Manifest PHS record were legible enough, but the base Form with Box labels and other pre-printed stuff was washed out. I got copies of more legible records and learned what was pre-printed on the Form from them.
You might try posting a copy of it here, perhaps in the 2nd gen Forum, to see if somebody could help you "translate" yours.
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