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so OPJTROPTOU E REPORT OF PHYSICAL EXAMINATION d (See AR 40-100 and 40-105) 5 a Instructions. -Unless otherwise prescribed, this form will be used for all physical examinations of officers, nurses, or warrant officers; applicants for appointment as such in the Regular Army, National Guard, or Officers' Reserve Corps; and enrollment in the Reserve Officers Training Corps. Use typewriter if practicable. Attach plain additional sheets if required. Cree Edna M. ---- 1. (Last name) (First name) (Middle initial) (Serial number) 2. Civilian applicant for appointment Age 35 Years of service (Grade) (Organization and arm or service) (Nearest birthday) (Whole number only) 3. Nature of examination 1 Appointment Component of Army 2 Army U.S. 4. Typhoid vaccination. No. series completed 4 Last series January , 1941 5. Date of last smallpox vaccination July 1942 Type of reaction Immune e 6. Other vaccination or immunity tests Typhus 1942 7. Medical history 3 Measles, Mumps, Whooping Cough in childhood. Strep. Throat 1928. Tonsill- ectomy and Adenoid 1928. No serious illneses. No history of Hay Fever, Asthma or Rheumatic Fever. 8. Eyes Normal Distant vision: Right 20/ 15 correctible to 20/ by 4 (Snellen type) Left 20/ 15 correctible to 20/ by 4 Near vision: Right J# 1 correctible to J# by 4 1 (Jaeger type) Left J# correctible to J# by 4 Refraction 5 (under cycloplegic): Right Not done Left Not done Color perception (red and green) 6 Normal 9. Ears Normal Hearing (low conversational voice): Right 20 /20. Left 20 /20. Audiometer (percent loss): Right -- Left -- 10. Nose and throat 11. Teeth: 7 Right (Examinee's) Left no space X 7 6 5 4 3 2 1 1 2 3 4 5 6 x 8 Indicate: Restorable carious teeth by O: nonrestorable carious teeth by /; missing natural teeth by X. 16 15 14 13 12 11 10 9 9 10 11 12 13 15 16 No Remarks, including other defects no space 38 Normal Classification Prosthetic dental appliances None 12. Posture Good Figure Medium Frame Medium (Excellent, good, fair, bad) (Slender, medium, stocky, obese) (Light, medium, heavy) 13. Temperature 98.6 Height 66 inches. Weight 157 pounds. Chest: Rest 37 inches; inspiration 38 inches; expiration 36 inches. Abdomen 33 inches. 14. Cardiovascular system: Heart Blood pressure: S. 128 D. 76 Pulse: Rate-Sitting 72 Immediately after exercise 92 , 80 Two minutes after exercise Character Regular Arteries Normal Varicose veins None 15. Respiratory system Normal 16. X-ray of chest 8 17. Skin and lymphatics Normal Endocrine system Normal 18. Bones, joints, and muscles Normal Feet Normal 19. Abdominal viscera Normal None Hemorrhoids None 20. Hernia 5 1 Appointment, promotion, retirement, annual, active duty, special. 2 Regular Army; National Guard; Officers' Reserve Corps; Reserve Officers' Training Corps. 3 If annual physical examination, record only for past year. 4 If annual physical examination, record only distant and near vision, and state whether defect is properly corrected. 5 When indicated. 110 qoue 6 7 If rejected for appointment in Regular Army because of malocclusion, send plaster models to the Surgeon General. Not required for annual physical examination. 8 Required for candidates for commission. W. D., A. G. o. Form No. 63 16-10006 August 1, 1939

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    "ocrText": "so\nOPJTROPTOU\nE\nREPORT OF PHYSICAL EXAMINATION\nd\n(See AR 40-100 and 40-105)\n5\na\nInstructions. -Unless otherwise prescribed, this form will be used for all physical examinations of officers, nurses, or warrant officers; applicants for appointment as such in the Regular Army, National\nGuard, or Officers' Reserve Corps; and enrollment in the Reserve Officers Training Corps. Use typewriter if practicable. Attach plain additional sheets if required.\nCree\nEdna\nM.\n----\n1.\n(Last name)\n(First name)\n(Middle initial)\n(Serial number)\n2. Civilian applicant for appointment\nAge\n35\nYears of service\n(Grade)\n(Organization and arm or service)\n(Nearest birthday)\n(Whole number only)\n3. Nature of examination 1\nAppointment\nComponent of Army 2\nArmy U.S.\n4. Typhoid vaccination. No. series completed\n4\nLast series January\n,\n1941\n5. Date of last smallpox vaccination July 1942\nType of reaction\nImmune\ne\n6. Other vaccination or immunity tests Typhus 1942\n7.\nMedical history 3 Measles, Mumps, Whooping Cough in childhood. Strep. Throat 1928. Tonsill-\nectomy and Adenoid 1928. No serious illneses. No history of Hay Fever, Asthma or\nRheumatic Fever.\n8. Eyes\nNormal\nDistant vision: Right 20/ 15\ncorrectible to 20/\nby 4\n(Snellen type) Left 20/ 15\ncorrectible to 20/\nby 4\nNear vision: Right J#\n1\ncorrectible to J#\nby 4\n1\n(Jaeger type) Left J#\ncorrectible to J#\nby 4\nRefraction 5 (under cycloplegic): Right\nNot done\nLeft\nNot done\nColor perception (red and green) 6\nNormal\n9. Ears\nNormal\nHearing (low conversational voice): Right 20 /20. Left 20 /20. Audiometer (percent loss): Right -- Left\n--\n10. Nose and throat\n11. Teeth: 7\nRight\n(Examinee's)\nLeft\nno space\nX 7 6 5 4 3 2 1 1 2 3 4 5 6 x 8\nIndicate: Restorable carious teeth by O: nonrestorable carious teeth\nby /; missing natural teeth by X.\n16 15 14 13 12 11 10 9 9 10 11 12 13 15 16\nNo\nRemarks, including other defects\nno space\n38\nNormal\nClassification\nProsthetic dental appliances\nNone\n12. Posture\nGood\nFigure\nMedium\nFrame\nMedium\n(Excellent, good, fair, bad)\n(Slender, medium, stocky, obese)\n(Light, medium, heavy)\n13. Temperature 98.6 Height 66 inches. Weight 157 pounds. Chest: Rest 37 inches; inspiration 38 inches;\nexpiration 36 inches. Abdomen 33 inches.\n14. Cardiovascular system: Heart\nBlood pressure: S. 128\nD.\n76\nPulse: Rate-Sitting 72\nImmediately after exercise 92\n,\n80\nTwo minutes after exercise\nCharacter\nRegular\nArteries\nNormal\nVaricose veins\nNone\n15. Respiratory system\nNormal\n16. X-ray of chest 8\n17. Skin and lymphatics Normal\nEndocrine system Normal\n18. Bones, joints, and muscles\nNormal\nFeet\nNormal\n19. Abdominal viscera\nNormal\nNone\nHemorrhoids\nNone\n20. Hernia\n5\n1 Appointment, promotion, retirement, annual, active duty, special.\n2 Regular Army; National Guard; Officers' Reserve Corps; Reserve Officers' Training Corps.\n3 If annual physical examination, record only for past year.\n4\nIf annual physical examination, record only distant and near vision, and state whether defect is properly corrected.\n5 When indicated.\n110 qoue\n6\n7 If rejected for appointment in Regular Army because of malocclusion, send plaster models to the Surgeon General.\nNot required for annual physical examination.\n8\nRequired for candidates for commission.\nW. D., A. G. o. Form No. 63\n16-10006\nAugust 1, 1939"
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