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D M R 29
THE AMERICAN RED CROSS
NURSING SERVICE
Physical Examination
1. Name of applicant metta P.leottrell
Address 3147 Prospector City beleveland State this
2. Age 35
Height
5ft.6"ymiles Weight 1274/4/15
3. General physique hard
M
4. Tendency to disease, or
inherited otherwise none. Imility several
times
5. Previous history in regard to serious illness or surgical operation
-
6.
Has she had rheumatism ? no
P.
7. Has she at present or has she ever had hernia ? no
8. Condition of teeth Good
9. Condition of feet hard
10. Abdomen and contained organs home
11. homel
Chest and contained organs
Girth; expiration
31"14
inches; inspiration
33 3/4 inches
Respiration, rate of
16
Heart, pulse rate
84
20
Right eye (Snellen)
20
; corrected to
; lens used
12. Vision:
Left eye (Snellen)
20
; corrected to
; lens used
20
13. Hearing: A. D normal
A. S.
homel
14. Urine examination:
Color Straw
Reaction aekaline
Specific gravity 1017
Albumen huma
Casts
June
Leucocytes Few
Sugar num
15. Do you recommend applicant for:
(a) General hospital service yes
8/10
ots
a
(b) Tropical service
-
19
16. Fill in name and number of base hospital, unit or detachment with which applicant is con-
nected:
5
Army base hospital
Naval base hospital
Emergency detachment
Navy detachment
Hospital unit
William a 1 chl import D.
Date June 9.1918
Address
5409 Brolley
Whillenex oh
All questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
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"ocrText": "D M R 29\nTHE AMERICAN RED CROSS\nNURSING SERVICE\nPhysical Examination\n1. Name of applicant metta P.leottrell\nAddress 3147 Prospector City beleveland State this\n2. Age 35\nHeight\n5ft.6\"ymiles Weight 1274/4/15\n3. General physique hard\nM\n4. Tendency to disease, or\ninherited otherwise none. Imility several\ntimes\n5. Previous history in regard to serious illness or surgical operation\n-\n6.\nHas she had rheumatism ? no\nP.\n7. Has she at present or has she ever had hernia ? no\n8. Condition of teeth Good\n9. Condition of feet hard\n10. Abdomen and contained organs home\n11. homel\nChest and contained organs\nGirth; expiration\n31\"14\ninches; inspiration\n33 3/4 inches\nRespiration, rate of\n16\nHeart, pulse rate\n84\n20\nRight eye (Snellen)\n20\n; corrected to\n; lens used\n12. Vision:\nLeft eye (Snellen)\n20\n; corrected to\n; lens used\n20\n13. Hearing: A. D normal\nA. S.\nhomel\n14. Urine examination:\nColor Straw\nReaction aekaline\nSpecific gravity 1017\nAlbumen huma\nCasts\nJune\nLeucocytes Few\nSugar num\n15. Do you recommend applicant for:\n(a) General hospital service yes\n8/10\nots\na\n(b) Tropical service\n-\n19\n16. Fill in name and number of base hospital, unit or detachment with which applicant is con-\nnected:\n5\nArmy base hospital\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nWilliam a 1 chl import D.\nDate June 9.1918\nAddress\n5409 Brolley\nWhillenex oh\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment."
}