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D MR Form No. 30 DUPLICATE THE COOSE Unit & W HUMANITY ASHINGTON topol en. copy pending NURSING SERVICE writing fbl-w score CERTIFICATE OF IMMUNITY credential Place Pa Date June 8 17 I certify that I have administered anti-typhoid vaccine as a prophylactic to C Hilen Scott in the following doses: ist dose. 3-00000000 c. c. Date Date Janual 8 17 2nd dose. c. c. Date 3rd dose c. C. Date Sming M. D. I certify that C Hilan Scott is satisfactorily protected by vaccination against smallpox. 8.Thing M. D. Fill in location of base hospital, unit or detachment with which service is desired: Army base hospital at Naval base hospital at Emergency detachment at FILED Navy detachment at Hospital unit * L. MAY 8 1920 Surgical section at Record Room This duplicate certificate should be forwarded by nurse to Chief Nurse of Unit or to Committee Organizing Detachment. Req. 17-478-April-3000.

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Document source extras
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Page context
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    "ocrText": "D MR Form No. 30\nDUPLICATE\nTHE COOSE\nUnit &\nW HUMANITY\nASHINGTON\ntopol en. copy pending\nNURSING SERVICE\nwriting fbl-w score\nCERTIFICATE OF IMMUNITY\ncredential\nPlace Pa\nDate June 8 17\nI certify that I have administered anti-typhoid vaccine as a prophylactic to\nC Hilen Scott\nin the following doses:\nist dose. 3-00000000 c.\nc.\nDate Date Janual 8 17\n2nd dose.\nc. c.\nDate\n3rd dose\nc. C.\nDate\nSming\nM. D.\nI certify that\nC Hilan Scott\nis satisfactorily protected by vaccination against smallpox.\n8.Thing\nM. D.\nFill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\nNaval base hospital at\nEmergency detachment at\nFILED\nNavy detachment at\nHospital unit * L.\nMAY 8 1920\nSurgical section at\nRecord Room\nThis duplicate certificate should be forwarded by nurse to Chief Nurse of Unit or to Committee\nOrganizing Detachment.\nReq. 17-478-April-3000."
}