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Hawaii Unit - Return to Mrs. E. Amick, Nursing Service
Form 1460
Rev. April 1942
l
American Red Cross
Dr. Christic
Physical Examination Record
Name Miss Reba Kathryn Beale
Date of birth June 6, 1904
Age 38
K
Home Address: City 3702 North Illinois
State Indianapolis, Ind.
a
+
PAST HISTORY
5
Give history of previous illness and treatments (medical and surgical) u C.B with
T
Hermaplasta rt uriginal 1916- masted
1
fallshing suffneuzia 1918-
5
Epilepsy or convulsive seizures-nervous or mental disease none.
Is there a history of tuberculosis in the family or among intimate associates? If so; state particulars.
name
PHYSICAL EXAMINATION
Ideal Wt.
Pulse 76
Temperature
98
Ht. 59/2" Wt. 92
for Ht.
General Good
appearance
Physique good
Nutrition
good
Skin and mucous membranes Good
Vision :
(Rt. eye
2/0/20)
(Rt. 20/20)
With glasses
Without glasses
(Lt. eye
30/20)
(Lt. 20 /20)
Evidence of disease:
Hearing:
(Rt. ear
15/15)
Evidence of disease
(Whispered voice)
(Lt. ear
15 /15)
(Lt. normal.
(Rt. Hashad rt monthing
Teeth
Good
Gums good
r
Artificial dentures more
5
Nose and throat normal
8
Lymph glands
none
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"ocrText": "Hawaii Unit - Return to Mrs. E. Amick, Nursing Service\nForm 1460\nRev. April 1942\nl\nAmerican Red Cross\nDr. Christic\nPhysical Examination Record\nName Miss Reba Kathryn Beale\nDate of birth June 6, 1904\nAge 38\nK\nHome Address: City 3702 North Illinois\nState Indianapolis, Ind.\na\n+\nPAST HISTORY\n5\nGive history of previous illness and treatments (medical and surgical) u C.B with\nT\nHermaplasta rt uriginal 1916- masted\n1\nfallshing suffneuzia 1918-\n5\nEpilepsy or convulsive seizures-nervous or mental disease none.\nIs there a history of tuberculosis in the family or among intimate associates? If so; state particulars.\nname\nPHYSICAL EXAMINATION\nIdeal Wt.\nPulse 76\nTemperature\n98\nHt. 59/2\" Wt. 92\nfor Ht.\nGeneral Good\nappearance\nPhysique good\nNutrition\ngood\nSkin and mucous membranes Good\nVision :\n(Rt. eye\n2/0/20)\n(Rt. 20/20)\nWith glasses\nWithout glasses\n(Lt. eye\n30/20)\n(Lt. 20 /20)\nEvidence of disease:\nHearing:\n(Rt. ear\n15/15)\nEvidence of disease\n(Whispered voice)\n(Lt. ear\n15 /15)\n(Lt. normal.\n(Rt. Hashad rt monthing\nTeeth\nGood\nGums good\nr\nArtificial dentures more\n5\nNose and throat normal\n8\nLymph glands\nnone"
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