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Form 596
Ophwoo
AMERICAN RED CROSS
JCR
Worwick NY.
(City and State in which examined)
DIVISION.
Sept 20
1918
Confidential Report of Medical Examiner
In the case
of anna L. Williams
Address
Warurek N.Y.
Questions to be Answered by Examining Physician.
Note 1. Personnel in the foreign service of the American Red Cross often live and work in such trying climates, amid such
insanitary surroundings, exposed to such malignant diseases, and under such a nervous strain incident to loneliness
and that he will feel the responsibility of his office, bearing in mind that upon his statements great reliance will
pointment. It is therefore expected that the Medical Examiner will make the examination thorough and circumstantial be
and expatriation, that only men and women of sound constitution and vigorous health should be recommended for ap-
placed by the American Red Cross. Every question should be answered as omissions will necessitate correspondence
as to the reasons.
Note 2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases
under each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability
of its recurrence in the less favorable conditions under which the applicant is to work.
I.A. What is the applicant's age?
I. A
39
B. Have you had previous acquaintance with the
applicant? How long?
B 2 yrs.
C. Have you treated him or her professionally ?
C. no.
For what disease or injury
D. Does the general appearance indicate vigor-
D
Gigerous health
ous, medium or delicate health?
E. State weight.
E. 173
,
Height.
78 1/2 unches
Nobust
Figure.
F. Is there any deformity or malformation?
F no.
G. What is the temperament, nervous or other-
G. Placid
wise?
II.
A
II. The Respiratory System.
yes 18 for min
A. Is the respiration full, easy and regular? State
the number of respirations in a minute.
/
B. Is there any tendency to cough, expectoration
B. No
or difficulty in breathing?
C. Does the physical examination reveal anything
C. ho.
whatever abnormal in the condition of the
respiratory organs? If yes, explain fully
and state your opinion as to its significance.
er
30
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"ocrText": "Form 596\nOphwoo\nAMERICAN RED CROSS\nJCR\nWorwick NY.\n(City and State in which examined)\nDIVISION.\nSept 20\n1918\nConfidential Report of Medical Examiner\nIn the case\nof anna L. Williams\nAddress\nWarurek N.Y.\nQuestions to be Answered by Examining Physician.\nNote 1. Personnel in the foreign service of the American Red Cross often live and work in such trying climates, amid such\ninsanitary surroundings, exposed to such malignant diseases, and under such a nervous strain incident to loneliness\nand that he will feel the responsibility of his office, bearing in mind that upon his statements great reliance will\npointment. It is therefore expected that the Medical Examiner will make the examination thorough and circumstantial be\nand expatriation, that only men and women of sound constitution and vigorous health should be recommended for ap-\nplaced by the American Red Cross. Every question should be answered as omissions will necessitate correspondence\nas to the reasons.\nNote 2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases\nunder each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability\nof its recurrence in the less favorable conditions under which the applicant is to work.\nI.A. What is the applicant's age?\nI. A\n39\nB. Have you had previous acquaintance with the\napplicant? How long?\nB 2 yrs.\nC. Have you treated him or her professionally ?\nC. no.\nFor what disease or injury\nD. Does the general appearance indicate vigor-\nD\nGigerous health\nous, medium or delicate health?\nE. State weight.\nE. 173\n,\nHeight.\n78 1/2 unches\nNobust\nFigure.\nF. Is there any deformity or malformation?\nF no.\nG. What is the temperament, nervous or other-\nG. Placid\nwise?\nII.\nA\nII. The Respiratory System.\nyes 18 for min\nA. Is the respiration full, easy and regular? State\nthe number of respirations in a minute.\n/\nB. Is there any tendency to cough, expectoration\nB. No\nor difficulty in breathing?\nC. Does the physical examination reveal anything\nC. ho.\nwhatever abnormal in the condition of the\nrespiratory organs? If yes, explain fully\nand state your opinion as to its significance.\ner\n30"
}