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u
C
approval
Form 596
AMERICAN RED CROSS
ensonse
Partland bre
(City and State in which examined)
D
Northwestern
DIVISION.
3.21.1919
11
Confidential Report of Medical Examiner
In the case of Miss Alice L. Buckland, R.N. (Red Cross Nurse)
ce
Address. 1563 East Stark St., Portland, Oregon.
Questions to be Answered by Examining Physician
Note 1. Personnel in the foreign service of the American Red Cross often live and work in such trying climates, amid such and
insanitary surroundings, exposed to such malignant diseases, and under such a nervous strain incident to loneliness
ment. It is therefore expected that the Medical Examiner will make the examination thorough and circumstantial and
expatriation, that only men and women of sound constitution and vigorous health should be recommended for appoint-
that he will feel the responsibility of his office, bearing in mind that upon his statements great reliance will be placed by
the American Red Cross. Every question should be answered as omissions will necessitate correspondence as to the
reasons.
Note 2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases
under each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability
of its recurrence in the less favorable conditions under which the applicant is to work.
10
2500
s
I.A. What is the applicant's age?
I. A 39
B. Have you had previous acquaintance with the
B Ro
applicant? How long?
Isbiegila 2000
C. Have you treated him or her professionally?
C
For what disease or injury?
boold
D
no
D. Does the general appearance indicate vigor-
ous, medium or delicate health?
benoffue 19V9 anll a
E 140
E. State weight.
5-5/2
.V1
Height.
ball
for
Figure.
Sick
F.
no
F. Is there any deformity .or malformation?
horrous
G. What is the temperament, nervous or other-
G.
wise?
II. A
II. The Respiratory System.
A. Is the respiration full, easy and regular State
V
the number of respirations in a minute.
yes. 18
B. Is there any tendency to cough, expectoration
B. no
or difficulty in breathing?
ard 10.A
$010.8
C. Does the physical examination reveal anything
C Mo
whatever abnormal in the condition of the
respiratory organs? If yes, explain fully
and state your opinion as to its significance.
01
vas stout ni 10 nnd well .a
oT 3
u
5
-
6
Page data
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- photo
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- 7bee97a1f526c19d
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Document data
- ID
- 2661175
- Core
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- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "u\nC\napproval\nForm 596\nAMERICAN RED CROSS\nensonse\nPartland bre\n(City and State in which examined)\nD\nNorthwestern\nDIVISION.\n3.21.1919\n11\nConfidential Report of Medical Examiner\nIn the case of Miss Alice L. Buckland, R.N. (Red Cross Nurse)\nce\nAddress. 1563 East Stark St., Portland, Oregon.\nQuestions to be Answered by Examining Physician\nNote 1. Personnel in the foreign service of the American Red Cross often live and work in such trying climates, amid such and\ninsanitary surroundings, exposed to such malignant diseases, and under such a nervous strain incident to loneliness\nment. It is therefore expected that the Medical Examiner will make the examination thorough and circumstantial and\nexpatriation, that only men and women of sound constitution and vigorous health should be recommended for appoint-\nthat he will feel the responsibility of his office, bearing in mind that upon his statements great reliance will be placed by\nthe American Red Cross. Every question should be answered as omissions will necessitate correspondence as to the\nreasons.\nNote 2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases\nunder each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability\nof its recurrence in the less favorable conditions under which the applicant is to work.\n10\n2500\ns\nI.A. What is the applicant's age?\nI. A 39\nB. Have you had previous acquaintance with the\nB Ro\napplicant? How long?\nIsbiegila 2000\nC. Have you treated him or her professionally?\nC\nFor what disease or injury?\nboold\nD\nno\nD. Does the general appearance indicate vigor-\nous, medium or delicate health?\nbenoffue 19V9 anll a\nE 140\nE. State weight.\n5-5/2\n.V1\nHeight.\nball\nfor\nFigure.\nSick\nF.\nno\nF. Is there any deformity .or malformation?\nhorrous\nG. What is the temperament, nervous or other-\nG.\nwise?\nII. A\nII. The Respiratory System.\nA. Is the respiration full, easy and regular State\nV\nthe number of respirations in a minute.\nyes. 18\nB. Is there any tendency to cough, expectoration\nB. no\nor difficulty in breathing?\nard 10.A\n$010.8\nC. Does the physical examination reveal anything\nC Mo\nwhatever abnormal in the condition of the\nrespiratory organs? If yes, explain fully\nand state your opinion as to its significance.\n01\nvas stout ni 10 nnd well .a\noT 3\nu\n5\n-\n6"
}