Yes, it was done in Napoli. I'm not sure about electronic but she did for sure get a sealed envelope that she gave to CBP. You would think in the year 2025 that it would be entirely digital or at least have access to copies at any of the civil surgeon locations if needed.
No idea. We thought it was standard procedure. The packet was sealed, she gave to the kind CBP woman. She opened it, looked at something, I *think* she took something out and stamped it, then gave the entire packet back. My wife is certain she put it into one of our bags after, but we were so tired and stressed about what might happen at the border that she doesn't remember. We just aren't sure now if we should submit the AOS as-is with what we have and wait for RFE later in case we find it or at least get a second exam done. Because the instructions state that having the medical exam within one year of submitting the AOS means she won't need a second medical exam, she thinks it means that we don't need to submit the I-693. I said otherwise. One would think it would all be on a server somewhere, but unlikely.