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DMR 29--N.E.D.
THE AMERICAN RED CROSS
DEPARTMENT OF NURSING
Physical Examination
1. Name of applicant Winifred Erobuie
Address
82 Bradwood
Gity Roshudale State
mass
2. Age
28
Height
56 in
Weight
147
3. General physique
w.d.n.
4. Tendency to disease, inherited or otherwise none
5. Previous history in regard to serious illness or surgical operation never any
serious illness or operative
6. Has she had rheumatism? no
7. Has she at present or has she ever had hernia? no
8. Condition of teeth
O.K.
9. Condition of feet
no flatfoot or calluses
10. Abdomen and contained organs O.K.
11. Chest and contained organs Q.K.
Girth; expiration
inches; inspiration
inches
Respiration, rate of
18
Heart, pulse rate
76
Right eye (Snellen)
2020
;
12. Vision:
corrected to slight approximation for
Left eye (Snellen)
20
20
;
corrected to which lens used are used for
glasses
13. Hearing: A. D. normal 5/15
A. S. normal
close work 15/15
14. Urine examination:
Color
n
Reaction ac
Specific gravity
10 20
Albumen 0
Casts
0
Leucocytes
O
Sugar
O
15. Do you recommend applicant for:
(a) General hospital service yes
(b) Tropical service
16. Fill in name and number of base hospital, unit or detachment with which applicant is con-
nected:
Army base hospital
Naval base hospital
Emergency detachment
Navy detachment
Hospital unit
Edward L. Young for
M. D.
Date
Dcc 6-1920
Address 27-9 clarendon st
All questions MUST be answered otherwise certificate will not be accepted
at headquarters.
To be forwarded to Chief Nurse of Unit or to the Local Committee Organizing
Detachment on Red Cross Nursing Service.
(SEE OTHER SIDE)
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"ocrText": "DMR 29--N.E.D.\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nPhysical Examination\n1. Name of applicant Winifred Erobuie\nAddress\n82 Bradwood\nGity Roshudale State\nmass\n2. Age\n28\nHeight\n56 in\nWeight\n147\n3. General physique\nw.d.n.\n4. Tendency to disease, inherited or otherwise none\n5. Previous history in regard to serious illness or surgical operation never any\nserious illness or operative\n6. Has she had rheumatism? no\n7. Has she at present or has she ever had hernia? no\n8. Condition of teeth\nO.K.\n9. Condition of feet\nno flatfoot or calluses\n10. Abdomen and contained organs O.K.\n11. Chest and contained organs Q.K.\nGirth; expiration\ninches; inspiration\ninches\nRespiration, rate of\n18\nHeart, pulse rate\n76\nRight eye (Snellen)\n2020\n;\n12. Vision:\ncorrected to slight approximation for\nLeft eye (Snellen)\n20\n20\n;\ncorrected to which lens used are used for\nglasses\n13. Hearing: A. D. normal 5/15\nA. S. normal\nclose work 15/15\n14. Urine examination:\nColor\nn\nReaction ac\nSpecific gravity\n10 20\nAlbumen 0\nCasts\n0\nLeucocytes\nO\nSugar\nO\n15. Do you recommend applicant for:\n(a) General hospital service yes\n(b) Tropical service\n16. Fill in name and number of base hospital, unit or detachment with which applicant is con-\nnected:\nArmy base hospital\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nEdward L. Young for\nM. D.\nDate\nDcc 6-1920\nAddress 27-9 clarendon st\nAll questions MUST be answered otherwise certificate will not be accepted\nat headquarters.\nTo be forwarded to Chief Nurse of Unit or to the Local Committee Organizing\nDetachment on Red Cross Nursing Service.\n(SEE OTHER SIDE)"
}