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DMR Form No. 29
7/11/17
2457
THE
MENTCAN RED GOOS
NURSING SERVICE
1418
WASHINGTON
BUSINESS
PHYSICAL EXAMINATION
I.
Name of applicant Luey Minnigerade
Address Columbia Hospital
City looshington State st
2. Age
46
Height 5ft. 4 1/2 in Weight 170 lb.
3. General physique Robush - well balanced
4. Tendency to disease, inherited or otherwise
none.
5. history or
Previous in regard to serious illness surgical operation none- -
6. Has she had rheumatism?
no
7. Has she at present or has she ever had hernia?
no
-
8. Condition of teeth good 26 teeth, A 2 parcelain; crown-
9. Condition of feet Good
IO. Abdomen and contained organs normal.
II. Chest and contained organs normal
Expiration 34
inches.
Inspiration
37
inches.
12. Vision: O.D. 15/20
Hearing: A. D. whisfer at 12 feet
A. S. whisper at "
"
O. S. 15/20.
NOTE: In case of refractive error state degree of correction by glasses.
I3. Urine examination:
Color acubes
Reaction asis
Specific gravity 1,020
Albumen o
-
Casts
Leucocytes 0
Sugar
14. Do you recommend applicant for:
(a) General hospital service
yes.
(b) Tropical service
yes.
OK
CHE
15. Fill in location of base hospital, unit or detachment with which service is desired:
Army base hospital at
Naval base hospital at
Emergency detachment
no 67
Navy detachment at
Hospital unit at
Surgical section at
Date All questions MUST be 1917
Address 133 abe.
the
M. D.
answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
Req. 17-833-May--20M
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Document data
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- Core
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- Type
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Document source extras
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"logicalDate": "1914-08-14",
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"ocrText": "DMR Form No. 29\n7/11/17\n2457\nTHE\nMENTCAN RED GOOS\nNURSING SERVICE\n1418\nWASHINGTON\nBUSINESS\nPHYSICAL EXAMINATION\nI.\nName of applicant Luey Minnigerade\nAddress Columbia Hospital\nCity looshington State st\n2. Age\n46\nHeight 5ft. 4 1/2 in Weight 170 lb.\n3. General physique Robush - well balanced\n4. Tendency to disease, inherited or otherwise\nnone.\n5. history or\nPrevious in regard to serious illness surgical operation none- -\n6. Has she had rheumatism?\nno\n7. Has she at present or has she ever had hernia?\nno\n-\n8. Condition of teeth good 26 teeth, A 2 parcelain; crown-\n9. Condition of feet Good\nIO. Abdomen and contained organs normal.\nII. Chest and contained organs normal\nExpiration 34\ninches.\nInspiration\n37\ninches.\n12. Vision: O.D. 15/20\nHearing: A. D. whisfer at 12 feet\nA. S. whisper at \"\n\"\nO. S. 15/20.\nNOTE: In case of refractive error state degree of correction by glasses.\nI3. Urine examination:\nColor acubes\nReaction asis\nSpecific gravity 1,020\nAlbumen o\n-\nCasts\nLeucocytes 0\nSugar\n14. Do you recommend applicant for:\n(a) General hospital service\nyes.\n(b) Tropical service\nyes.\nOK\nCHE\n15. Fill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\nNaval base hospital at\nEmergency detachment\nno 67\nNavy detachment at\nHospital unit at\nSurgical section at\nDate All questions MUST be 1917\nAddress 133 abe.\nthe\nM. D.\nanswered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-833-May--20M"
}