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eth
F. Has the applicant ever had any of the diseases
F appendixe burneda
M
of the digestive system? If yes, describe.
Inquire particularly regarding appendicitis.
1917
a
VI. The Genito-Urinary System.
VI.
A. The specific gravity and reaction of the urine?
A
1,031 strongly acid
B
I
B. Is any albumen present, by heat and acid, or
by Heller's test? Both tests required.
meg
C. Is any sugar present by Fehling's tests or by
fermentation ?
meg
D. Results of microscopic analysis, if necessary.
D n made
E. Is there any derangment of the bladder?
now
F. Of the kidneys?
F me
VII.
no
VII. The Cutaneous System.
Has there ever been or is there any disease or
functional derangement of the system
VIII. The Organs of Sense.
VIII.
A. The sight. Does the condition of the eyes in-
Thomas
dicate that they should be examined by a
specialist?
B. The hearing. Any discharge from ears?
B ammed
C. Other senses.
C amal
IX. Have there been any cases among the parents,
IX.
brothers or sisters of the applicant of
A. Consumption?
A me.
B. Insanity ?
Bue
C. Is there any predisposition hereditary or ac-
C. he
quired, to gout, rheumatism, cancer, arterial
disease, diabetes, or nervous disorders, es-
pecially headaches, insomnia, nervous ex-
haustion, chorea or epilepsy? If yes, state
nature.
X. A. If the applicant is a woman, is she now suf-
X. A
hoursal
fering or has she ever suffered from uterine
or menstrual disorder. (It is desirable that
particular attention be given to this inquiry
as the climate overseas bears heavily on those
thus affected.)
5
6
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"ocrText": "to\neth\nF. Has the applicant ever had any of the diseases\nF appendixe burneda\nM\nof the digestive system? If yes, describe.\nInquire particularly regarding appendicitis.\n1917\na\nVI. The Genito-Urinary System.\nVI.\nA. The specific gravity and reaction of the urine?\nA\n1,031 strongly acid\nB\nI\nB. Is any albumen present, by heat and acid, or\nby Heller's test? Both tests required.\nmeg\nC. Is any sugar present by Fehling's tests or by\nfermentation ?\nmeg\nD. Results of microscopic analysis, if necessary.\nD n made\nE. Is there any derangment of the bladder?\nnow\nF. Of the kidneys?\nF me\nVII.\nno\nVII. The Cutaneous System.\nHas there ever been or is there any disease or\nfunctional derangement of the system\nVIII. The Organs of Sense.\nVIII.\nA. The sight. Does the condition of the eyes in-\nThomas\ndicate that they should be examined by a\nspecialist?\nB. The hearing. Any discharge from ears?\nB ammed\nC. Other senses.\nC amal\nIX. Have there been any cases among the parents,\nIX.\nbrothers or sisters of the applicant of\nA. Consumption?\nA me.\nB. Insanity ?\nBue\nC. Is there any predisposition hereditary or ac-\nC. he\nquired, to gout, rheumatism, cancer, arterial\ndisease, diabetes, or nervous disorders, es-\npecially headaches, insomnia, nervous ex-\nhaustion, chorea or epilepsy? If yes, state\nnature.\nX. A. If the applicant is a woman, is she now suf-\nX. A\nhoursal\nfering or has she ever suffered from uterine\nor menstrual disorder. (It is desirable that\nparticular attention be given to this inquiry\nas the climate overseas bears heavily on those\nthus affected.)\n5\n6"
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