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I e B. If a wife, is she now pregnant? to arli 7 XI. Has the applicant ever had- oviteogib orls XI. A. Rheumatism, acute or chronic? IV A no TV B. Malaria? B. no I C. Other fever? C. ho a D. Any disease or injury not included in pre- D no etast yd ceding questions? - XII. Has the applicant noticed any recent marked XII. no TO atas) vd el s gain or loss in flesh ? 31 10 a XIII. Would you recommend the applicant to a XIII. you the orrought S reputable Life Insurance Company as a pru- dent risk? XIV. Do you professionally consider the applicant XIV. yes a suitable person, physically, for appointment to overseas work? ai 10 mood 19V9 exH odt lo XV. Would a tropical climate be likely to induce XV. No disease or cause disablement ? IIII XVI. Are there any facts known to you, or dis- XVI. M covered by you, not brought out in the above questions, affecting or likely to affect the benimaxe ad bítioda valt health of the applicant If so, please state them. XVII. Is there, in general, a soundness of constitu- XVII. Yes tion and a vigor of health which give reason- able probability that the applicant can endure XI the physical and mental strain of overseas : to sid to 10 work? XVIII. When was the applicant last successfully XVIII. 7.2.1919 vaccinated? XIX. Has the applicant had typhoid fever or the anti-typhoid inoculation? XIX. Typhone 898- Quoc (2) 1918 NOTE Before final credentials are issued to any person enrolled for foreign service for the American Red Cross, a certificate or certificates must be furnished of vaccination and inoculation against smallpox, typhoid and para- typhoid fever, or in lieu thereof, a certificate by a physician, approved by the Medical Adviser of the Division receiving the application, that such person has recently suffered from the disease for the prevention of which there has been no immunization by vaccination or preventive inoculation. city Signature of Medical Examiner. MARK RDSON M. D. IDSTON, MASS Address

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    "ocrText": "I\ne\nB. If a wife, is she now pregnant?\nto arli 7\nXI. Has the applicant ever had-\noviteogib orls\nXI.\nA. Rheumatism, acute or chronic?\nIV\nA no\nTV\nB. Malaria?\nB. no\nI\nC. Other fever?\nC. ho\na\nD. Any disease or injury not included in pre-\nD no\netast yd\nceding questions?\n-\nXII. Has the applicant noticed any recent marked\nXII.\nno TO atas) vd el s\ngain or loss in flesh ?\n31 10 a\nXIII. Would you recommend the applicant to a\nXIII. you the orrought\nS\nreputable Life Insurance Company as a pru-\ndent risk?\nXIV. Do you professionally consider the applicant\nXIV. yes\na suitable person, physically, for appointment\nto overseas work?\nai 10 mood 19V9 exH\nodt lo\nXV. Would a tropical climate be likely to induce\nXV. No\ndisease or cause disablement ?\nIIII\nXVI. Are there any facts known to you, or dis-\nXVI. M\ncovered by you, not brought out in the above\nquestions, affecting or likely to affect the\nbenimaxe ad bítioda valt\nhealth of the applicant If so, please state\nthem.\nXVII. Is there, in general, a soundness of constitu-\nXVII. Yes\ntion and a vigor of health which give reason-\nable probability that the applicant can endure\nXI\nthe physical and mental strain of overseas\n: to sid to 10\nwork?\nXVIII. When was the applicant last successfully\nXVIII. 7.2.1919\nvaccinated?\nXIX. Has the applicant had typhoid fever or the\nanti-typhoid inoculation?\nXIX. Typhone 898- Quoc (2) 1918\nNOTE\nBefore final credentials are issued to any person enrolled for foreign service for the American Red Cross, a\ncertificate or certificates must be furnished of vaccination and inoculation against smallpox, typhoid and para-\ntyphoid fever, or in lieu thereof, a certificate by a physician, approved by the Medical Adviser of the Division\nreceiving the application, that such person has recently suffered from the disease for the prevention of which there\nhas been no immunization by vaccination or preventive inoculation.\ncity\nSignature of Medical Examiner.\nMARK RDSON\nM. D.\nIDSTON, MASS\nAddress"
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