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E 13. Abdomen: (condition of wall, scars, herniae, and abnormality of viscera) normal 5 Circumference of abdomen at umbilicus 29" 14. Nervous system: (note organic or functional disorders) normal 15. Urinalysis: Sp. Gr. 1022 Albumin Mg Sugar my Microscopical normal Marian (3complitically 16. Date of immunization against, Smallpox 1938 Typhoid 1934 17. Remarks on abnormalities not otherwise noted or sufficiently described on this blank: None bedoattoO Is fit to active duty the applicant perform (Military, Disaster, etc. ?) yrs If not, state type of duty she is physically fitted to perform - stote 910 Date 7/10/40 Edum 2mithington Examiner 1sthpt Mid Rus. bns dreeT .8 tolable 6 7 & 9 10 " 13 okline .01 - my - 18/40 be 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 (Jeel bas seloaum segoE) II Indicate missing teeth by "X", bridge work by C crowns by plates by word "plate" sedoni is SI 5 All questions MUST be answered; otherwise certificate will not be accepted at Head- a quarters. To be forwarded to the Local Committee on Red Cross Nursing Service. 3 1. Be sure that all items are filled in before forwarding. Make definite statements in all instances. a 2. Give age in years, height in inches, weight in pounds. esia 12. Chest measurements should be in total inches. & a boola

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