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I
C
K
M
TS,
D.M.R. FORM No. 30
7911
DUPLICATE
American Red Cross Fursing Serbice
CERTIFICATE OF IMMUNITY
D
Place. Maronefield mass
9
Date
march 30 1917
5
e
I certify that I have administered anti-typhoid vaccine as a prophylactic to
S
many a. Hichey # 7911
in the following doses:
1st dose
0.5
c. c.
Date march 9 1917
2nd dose
10
c. c.
Date march 19 1917
3rd dose
1.0
c. c.
Date
" 30.1917
\
W., a. Hnsley
M. D.
I certify that
many a. Hickey
is satisfactorily protected by vaccination against smallpox.
W. a. Hosley
M. D.
This duplicate certificate should be forwarded by nurse to the Chairman National Commit=
tee on Nursing Service, American Red Cross, Washington, D. c., after completion of treatment.
REQ. 16-600-JULY-3000
-
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"ocrText": "I\nC\nK\nM\nTS,\nD.M.R. FORM No. 30\n7911\nDUPLICATE\nAmerican Red Cross Fursing Serbice\nCERTIFICATE OF IMMUNITY\nD\nPlace. Maronefield mass\n9\nDate\nmarch 30 1917\n5\ne\nI certify that I have administered anti-typhoid vaccine as a prophylactic to\nS\nmany a. Hichey # 7911\nin the following doses:\n1st dose\n0.5\nc. c.\nDate march 9 1917\n2nd dose\n10\nc. c.\nDate march 19 1917\n3rd dose\n1.0\nc. c.\nDate\n\" 30.1917\n\\\nW., a. Hnsley\nM. D.\nI certify that\nmany a. Hickey\nis satisfactorily protected by vaccination against smallpox.\nW. a. Hosley\nM. D.\nThis duplicate certificate should be forwarded by nurse to the Chairman National Commit=\ntee on Nursing Service, American Red Cross, Washington, D. c., after completion of treatment.\nREQ. 16-600-JULY-3000\n-"
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