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D MR Form No. 29
Outh
Phone:
THE WASHINGTON COOSE
NURSING SERVICE
PHYSICAL EXAMINATION
I. Name of applicant (Niss) Ethel Iranoil
Address. 705 Dallas ave City Sahma State ala
2. Age 34
Height 5-7% Weight 160
3. General physique. Erect.Well mouristed Symmetrical
4. Tendency disease,
to inherited or otherwise None
5. Previous history in regard to serious illness or surgical operation appendectomy
5 yrs ago complete recovery
6. Has she had rheumatism?
so
7. Has she at present or has she ever had hernia? no
9. Condition of feet good
8. Condition of teeth good
Normal
IO. Abdomen and contained organs
normal
II. Chest and contained organs
Expiration 32 1/2 inches.
Inspiration
36% inches.
12.
Vision : O. D.20/20 glasses
normal
Hearing: A. D.
O. S. 20/20
for astygmatism A.
Normal
S.
NOTE: In case of refractive error state degree of correction by glasses.
13. Urine examination:
Color. amber
and
Reaction
Specific gravity 1022
Albumen
some
Casts
none
Leucocytes None
Sugar
sone
14. Do you recommend applicant for:
(a) General hospital service
orthopedic singery
OK
(b) Tropical service.
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 at
Navy detachment atl
Hospital unit at
Bilfast Preloud or mutin D. frience
May ameral Weddhwart
Surgical section at
Date DEC 11.1917
John Nurres M.
Salmadela
Address
All questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
w
Req. 17-833-May--20M
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- Core
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Context sent to Scholar
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"ocrText": "D MR Form No. 29\nOuth\nPhone:\nTHE WASHINGTON COOSE\nNURSING SERVICE\nPHYSICAL EXAMINATION\nI. Name of applicant (Niss) Ethel Iranoil\nAddress. 705 Dallas ave City Sahma State ala\n2. Age 34\nHeight 5-7% Weight 160\n3. General physique. Erect.Well mouristed Symmetrical\n4. Tendency disease,\nto inherited or otherwise None\n5. Previous history in regard to serious illness or surgical operation appendectomy\n5 yrs ago complete recovery\n6. Has she had rheumatism?\nso\n7. Has she at present or has she ever had hernia? no\n9. Condition of feet good\n8. Condition of teeth good\nNormal\nIO. Abdomen and contained organs\nnormal\nII. Chest and contained organs\nExpiration 32 1/2 inches.\nInspiration\n36% inches.\n12.\nVision : O. D.20/20 glasses\nnormal\nHearing: A. D.\nO. S. 20/20\nfor astygmatism A.\nNormal\nS.\nNOTE: In case of refractive error state degree of correction by glasses.\n13. Urine examination:\nColor. amber\nand\nReaction\nSpecific gravity 1022\nAlbumen\nsome\nCasts\nnone\nLeucocytes None\nSugar\nsone\n14. Do you recommend applicant for:\n(a) General hospital service\northopedic singery\nOK\n(b) Tropical service.\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 at\nNavy detachment atl\nHospital unit at\nBilfast Preloud or mutin D. frience\nMay ameral Weddhwart\nSurgical section at\nDate DEC 11.1917\nJohn Nurres M.\nSalmadela\nAddress\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nw\nReq. 17-833-May--20M"
}