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K.
THE AMERICAN RED CROSS
5
NURSING SERVICE
ess,
Physical Examination
I. Name of
applicant Myrtle Nelhe Amer eleiman
Address 31 City State
1
My
2. Age
Height Weight 180
3. General physique rnd
+
4. Tendency disease, None
to inherited or otherwise
5. Previous history in regard to serious illness or surgical operation
any 1909
N
Writish
to in for No a pun Menthol
e
6. Has she had rheumatism?
-
Has she at present or has, she ever had hernia? Hermin m magin
-
7.
Condition of teeth and exacted on 1500 completions
e
8.
Condition of feet
land
9.
IO. Abdomen and contained organs
Normal
II. Chest and contained organs
Normal
Girth; expiration
40
inches;
inspiration 44
inches
Respiration, rate of
201 Heart, pulse rate 80
Right eye (Snellen) 20/35-f ; corrected to 20/25-1 ; lens used +1.00egex.80
I2. Vision:
1
Left eye (Snellen) 20/30
; corrected to: 20/20-1 ; lens used +.75cylx90
13. Hearing: A. D 18/20
A. S. 18/20
14. Urine examination
Color Showorotand Reaction styfittly did
1020
Specific gravity
Albumen
to
Casts to
Leucocytes.
to
Sugar
to
I5. Do you recommend applicant for:
oll (
(a) General hospital service Jrs
To
(b) Tropical service yes
16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:
Army base hospital
2
Naval base hospital
Emergency detachment
Navy detachment
8
Hospital unit
Thank Hedge M.
D.
Date my 25th 1918
Address Freedenth hd.
Alf questions MUST be answered; otherwise certificate will not be accepted at head-
quarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
Req. 17-2125B-20M-Nov.
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DTO data
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"ocrText": "K.\nTHE AMERICAN RED CROSS\n5\nNURSING SERVICE\ness,\nPhysical Examination\nI. Name of\napplicant Myrtle Nelhe Amer eleiman\nAddress 31 City State\n1\nMy\n2. Age\nHeight Weight 180\n3. General physique rnd\n+\n4. Tendency disease, None\nto inherited or otherwise\n5. Previous history in regard to serious illness or surgical operation\nany 1909\nN\nWritish\nto in for No a pun Menthol\ne\n6. Has she had rheumatism?\n-\nHas she at present or has, she ever had hernia? Hermin m magin\n-\n7.\nCondition of teeth and exacted on 1500 completions\ne\n8.\nCondition of feet\nland\n9.\nIO. Abdomen and contained organs\nNormal\nII. Chest and contained organs\nNormal\nGirth; expiration\n40\ninches;\ninspiration 44\ninches\nRespiration, rate of\n201 Heart, pulse rate 80\nRight eye (Snellen) 20/35-f ; corrected to 20/25-1 ; lens used +1.00egex.80\nI2. Vision:\n1\nLeft eye (Snellen) 20/30\n; corrected to: 20/20-1 ; lens used +.75cylx90\n13. Hearing: A. D 18/20\nA. S. 18/20\n14. Urine examination\nColor Showorotand Reaction styfittly did\n1020\nSpecific gravity\nAlbumen\nto\nCasts to\nLeucocytes.\nto\nSugar\nto\nI5. Do you recommend applicant for:\noll (\n(a) General hospital service Jrs\nTo\n(b) Tropical service yes\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital\n2\nNaval base hospital\nEmergency detachment\nNavy detachment\n8\nHospital unit\nThank Hedge M.\nD.\nDate my 25th 1918\nAddress Freedenth hd.\nAlf questions MUST be answered; otherwise certificate will not be accepted at head-\nquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-2125B-20M-Nov."
}