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# 12319 P.H cal8
S
C
AMERICAN RED CROSS NURSING SERVICE
PHYSICAL EXAMINATION
L
e
Name of Applicant,
alice B.B. Corrover R.h.
a
Age 52
Height 5-4/sthor) um
Weight
D
3. General appearance
Ingood he alth elender but musually
Grogoos TO and strong
--
4. Are your parents living ?
c
5.
If not, at what age and of what disease did each die?
mother. Carceuoura
e
of determs et xxys. Father rid of opopley at 80 oyrs
6. Tendency to disease, inherited or otherwise ?
Carcinowa if that is
B.
considered benitary
7. Prévious history in regard to serious illness or surgical operation
for polypatin ( not malequeux) over ten yearsy
Heptrictomy (voquied)
P.
8. Have you had rheumatism ?
slight recasional bithritis - bever I bady
9. Have you at present or have you ever had hernia ?
No
10. Condition of teeth
all, out Excepa 4 - slight paperhoes teeth inthone
11. Condition of feet
Normal
Good false
12. Abdomen and contained organs
Normal
13. Chest and contained organs
Heart things normal.
Expiration
2 9 / 2 inches.
Inspiration
321/2 inches.
14.
Vision : O.D 6/200 Corsetsdto 20/20
Hearing : A.D.
20/20
O. S. 6/200 Correctot to 30/20
A.S. 30/20
15. Urine Examination :
Color
amber. noneral
acid
Reaction
Specific Gravity 1017
none
Albumen
Casts
O
Leucocytes few outh
Sugar
0
Ry
16. Remarks as to fitness of applicant for :
(a) General hospital service
Beyond the arrage. Had had
Extensive in was hospital ( ur year in company
(b) Tropical service
Good (y 100 lat Paugnton years destruct supe mouths
Eleogia Aut had to jise up as desculary was
declaring chronic
Bts orming
M. D.
Date
Vr 19.1917
Address
116 East 58988
To be forwarded by the nurse, with duplicate Certificate of Immunity, to Chairman National Committee on
Nursing Service, American Red Cross, Washington, D C.
Page data
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- Source index
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Document data
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- 2661269
- Core
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- Type
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"ocrText": "# 12319 P.H cal8\nS\nC\nAMERICAN RED CROSS NURSING SERVICE\nPHYSICAL EXAMINATION\nL\ne\nName of Applicant,\nalice B.B. Corrover R.h.\na\nAge 52\nHeight 5-4/sthor) um\nWeight\nD\n3. General appearance\nIngood he alth elender but musually\nGrogoos TO and strong\n--\n4. Are your parents living ?\nc\n5.\nIf not, at what age and of what disease did each die?\nmother. Carceuoura\ne\nof determs et xxys. Father rid of opopley at 80 oyrs\n6. Tendency to disease, inherited or otherwise ?\nCarcinowa if that is\nB.\nconsidered benitary\n7. Prévious history in regard to serious illness or surgical operation\nfor polypatin ( not malequeux) over ten yearsy\nHeptrictomy (voquied)\nP.\n8. Have you had rheumatism ?\nslight recasional bithritis - bever I bady\n9. Have you at present or have you ever had hernia ?\nNo\n10. Condition of teeth\nall, out Excepa 4 - slight paperhoes teeth inthone\n11. Condition of feet\nNormal\nGood false\n12. Abdomen and contained organs\nNormal\n13. Chest and contained organs\nHeart things normal.\nExpiration\n2 9 / 2 inches.\nInspiration\n321/2 inches.\n14.\nVision : O.D 6/200 Corsetsdto 20/20\nHearing : A.D.\n20/20\nO. S. 6/200 Correctot to 30/20\nA.S. 30/20\n15. Urine Examination :\nColor\namber. noneral\nacid\nReaction\nSpecific Gravity 1017\nnone\nAlbumen\nCasts\nO\nLeucocytes few outh\nSugar\n0\nRy\n16. Remarks as to fitness of applicant for :\n(a) General hospital service\nBeyond the arrage. Had had\nExtensive in was hospital ( ur year in company\n(b) Tropical service\nGood (y 100 lat Paugnton years destruct supe mouths\nEleogia Aut had to jise up as desculary was\ndeclaring chronic\nBts orming\nM. D.\nDate\nVr 19.1917\nAddress\n116 East 58988\nTo be forwarded by the nurse, with duplicate Certificate of Immunity, to Chairman National Committee on\nNursing Service, American Red Cross, Washington, D C."
}