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W
as
E
in
M
5
I
rs
(A
ch
D M R 30
5
ORIGINAL
NURSING SERVICE
CERTIFICATE OF IMMUNITY
Pari Typhoid
Place Cedar Raped Lowa
J.
and
Date face 10 1918
Miss I certifit that have Christians, 1/2 c. c. Date
I administer ed vaccine as a prophylactic
to
Christy
in the following doses:
DEC 19.1917
1st dose
2nd dose
1- c. c.
3rd dose
1- c. c.
Date
M. D.
I
certify that Miss Christy I Christians
is vaccination against smallpox.
Fill
satisfactorily in location of protected Base Hospital, by Unit or Detachment with Attachmon which /service is desired:
M. D.
Army Base Hospital at
Naval Base Hospital at
Emergency Detachment at
Navy Detachment at
Hospital Unit at
Surgical Section at
This certificate to be retained by the nurse, Chief Nurse of Unit or by Committee Organizing
Detachment and, if assigned to duty, should be presented to the Medical Officer as evidence of her
immunity.
Req. 17-919-May-I5M
2
2
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