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OCR Page 1 of 3Smith, Miss Josephine
212 Mt. Vernon Ave
Orange, N.J.
1. OCCUPATION
Painted With U.S.R. eight years. Single.
2.
AGE
28 years
3. FAMILY HISTORY
Negative.
4.
PERSONAL HISTORY
Children's diseases
5.
PHYSIQUE
Weight 1061bs.
Heighth 5ft.
Posture good
6. CIRCULATION
Pulse 70 regular
Bd. P. 120/80
Heart sounds clear normal.
7. LUNGS
Normal
8. GASTRO INTESTINAL
Nervous indigestion
9. GENITO URINARY
Last periol had only one day. Due to nervousness
about recent events.
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