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I
I
N
M
2BORD 038 MADIA3MA
disease or functional derangement of the
respiratory system? If yes, state particu-
lars.
mild fluel in 1918
D nosting elect
an
D. Has the applicant ever suffered from any
TS.
S
(b
N
tenimax3
lo tregs!
E. What is the chest circumference?
E 32 m
D
33
an
Upon full inspiration ?
u
5
Upon full expiration?
29 in
III. The Circulatory System.
A. What is the temperature of the body? (If
III.
A
98. 6
over 99° in the mouth, try another day.)
B. Give the rate and other qualities of the pulse.
Record blood-pressure.
regular-full
B Pulu - setting 72-
D
C. Does it intermit, or become irregular or un-
equal?
C no Pulue after
D. Does physical examination reveal anything
whatever abnormal in the conditions of the
at after murmer aultines
eterning times exeruse mitral a 120- systolic t - Impure heart need 72
heart or blood vessels ?
stylinesy after normal blood pressure -
12/0/80 in shrie minutes
E. Has the applicant ever suffered from any
disease of the circulatory system? If yes,
present curdine
describe.
now in past
IV. The Nervous System.
IV.
Has there ever been or is there any disease or
northing ennormal
functional derangement of the brain or
other parts of the nervous system If yes,
state particulars. Inquire particularly re-
garding headaches, insomnia, nervous ex-
haustion, chorea or epilepsy and insanity.
V. The Digestive System.
V.
Has the applicant any disease or functional de-
no Issentially meg.
rangement?
A. Of the stomach?
A no
B. Of the intestines?
B: no
C. Of the liver?
C. no
D. Has there been or is there any tendency to
D
no
chronic constipation?
E. To diarrhea?
E no
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Document data
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DTO data
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"ocrText": "I\nI\nN\nM\n2BORD 038 MADIA3MA\ndisease or functional derangement of the\nrespiratory system? If yes, state particu-\nlars.\nmild fluel in 1918\nD nosting elect\nan\nD. Has the applicant ever suffered from any\nTS.\nS\n(b\nN\ntenimax3\nlo tregs!\nE. What is the chest circumference?\nE 32 m\nD\n33\nan\nUpon full inspiration ?\nu\n5\nUpon full expiration?\n29 in\nIII. The Circulatory System.\nA. What is the temperature of the body? (If\nIII.\nA\n98. 6\nover 99° in the mouth, try another day.)\nB. Give the rate and other qualities of the pulse.\nRecord blood-pressure.\nregular-full\nB Pulu - setting 72-\nD\nC. Does it intermit, or become irregular or un-\nequal?\nC no Pulue after\nD. Does physical examination reveal anything\nwhatever abnormal in the conditions of the\nat after murmer aultines\neterning times exeruse mitral a 120- systolic t - Impure heart need 72\nheart or blood vessels ?\nstylinesy after normal blood pressure -\n12/0/80 in shrie minutes\nE. Has the applicant ever suffered from any\ndisease of the circulatory system? If yes,\npresent curdine\ndescribe.\nnow in past\nIV. The Nervous System.\nIV.\nHas there ever been or is there any disease or\nnorthing ennormal\nfunctional derangement of the brain or\nother parts of the nervous system If yes,\nstate particulars. Inquire particularly re-\ngarding headaches, insomnia, nervous ex-\nhaustion, chorea or epilepsy and insanity.\nV. The Digestive System.\nV.\nHas the applicant any disease or functional de-\nno Issentially meg.\nrangement?\nA. Of the stomach?\nA no\nB. Of the intestines?\nB: no\nC. Of the liver?\nC. no\nD. Has there been or is there any tendency to\nD\nno\nchronic constipation?\nE. To diarrhea?\nE no"
}