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Hawaii Unit: Return to Mrs. Amick, Nursing Service
Form 1460
Rev. April 1942
Mrs.
Dr.Chris tic
American Red Cross
I
Physical Examination Record
M
Date of birth Aug. 7, 1905 Age 38
/
Name Mrs. Maude Best
State
M
4
Home Address: City 637 N. King St. Xenia
OHIO
a
PAST HISTORY
adenoma
and
e
Give history of previous illness and treatments (medical and surgical) Addrown of Thyrical
not, terie 1923 agfundi day 1937
M.
no other tofic Denins elemin
Epilepsy or convulsive seizures-nervous or mental disease
M
-
more
at
3
Is there a history of tuberculosis in the family or among intimate associates? If so, state particulars.
e
none.
M.
M
S
PHYSICAL EXAMINATION,
5
Pulse 74
Temperature
987 Ht. off 4 Wt. 125
Ideal Wt.
for Ht
General appearance good
A
Physique
Nutrition good
Skin and mucous membranes 900
Vision :
(Rt. eye
W
(20)
(Rt.
/20)
With glasses
Without glasses
(Lt. eye
(Lt.
/20)
Evidence of disease: nown
Hearing:
(Rt. ear
10/15)
Evidence of disease
(Rt. (Lt. nour
(Whispered voice)
(Lt. ear
/15)
Teeth Increderature restruction & plateral et notan below.
Gums good.
Artificial dentures Rileration of 2nd molay Wth Aidy uffire
w
Nose
and throat Townill soull not infacted.
Restoration
Lymph glands none.
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"ocrText": "B\ne c\n+\nHawaii Unit: Return to Mrs. Amick, Nursing Service\nForm 1460\nRev. April 1942\nMrs.\nDr.Chris tic\nAmerican Red Cross\nI\nPhysical Examination Record\nM\nDate of birth Aug. 7, 1905 Age 38\n/\nName Mrs. Maude Best\nState\nM\n4\nHome Address: City 637 N. King St. Xenia\nOHIO\na\nPAST HISTORY\nadenoma\nand\ne\nGive history of previous illness and treatments (medical and surgical) Addrown of Thyrical\nnot, terie 1923 agfundi day 1937\nM.\nno other tofic Denins elemin\nEpilepsy or convulsive seizures-nervous or mental disease\nM\n-\nmore\nat\n3\nIs there a history of tuberculosis in the family or among intimate associates? If so, state particulars.\ne\nnone.\nM.\nM\nS\nPHYSICAL EXAMINATION,\n5\nPulse 74\nTemperature\n987 Ht. off 4 Wt. 125\nIdeal Wt.\nfor Ht\nGeneral appearance good\nA\nPhysique\nNutrition good\nSkin and mucous membranes 900\nVision :\n(Rt. eye\nW\n(20)\n(Rt.\n/20)\nWith glasses\nWithout glasses\n(Lt. eye\n(Lt.\n/20)\nEvidence of disease: nown\nHearing:\n(Rt. ear\n10/15)\nEvidence of disease\n(Rt. (Lt. nour\n(Whispered voice)\n(Lt. ear\n/15)\nTeeth Increderature restruction & plateral et notan below.\nGums good.\nArtificial dentures Rileration of 2nd molay Wth Aidy uffire\nw\nNose\nand throat Townill soull not infacted.\nRestoration\nLymph glands none."
}