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DMR29
THE AMERICAN RED CROSS
saRC
E
DEPARTMENT OF NURSING
5-311-219-15
Physical Examination
1. Name of applicant Florence me. Candlies Peter
Address 3334 Chestnul St City Peula
State Penn
2. Age
35
Height
64 1/4 Weight 153
3. General physique
Good - well developed
4. Tendency to disease, inherited or otherwise none
5.
Previous history in regard to serious illness or surgical operation negative
no
6. Has she had rheumatism ?
7. Has she at present or has she ever had hernia?
no
8.
Condition
of
teeth Good- none missing.
9. Condition of feet slight flat feet no inconvenience
10. Abdomen and contained organs
normal
11. Chest and contained organs
normal
Girth; expiration
323/4
inches; inspiration
353/4 inches
Respiration, rate of
18
Heart, pulse rate 74
Right eye (Snellen) 20/30m ; corrected to 20/20 ; lens used
12. Vision :
Left eye (Snellen) 20/20 ; corrected to 20/10/pthy ; lens used %502+9544960
P.K. schwork
13. Hearing: A. D 15/15
A. S
15/15
14. Urine examination:
Color Light ambre
acid
Reaction
Specific gravity 1020
Albumen negative
Casts none
Leucocytes occasional
Sugar negative
15. Do you recommend applicant for:
(a) General hospital service yrs
ethe
(b) Tropical service
yrs.
16. Fill in name and number of base hospital, unit or detachment with which applicant is connected :
Army base hospital
Naval base hospital
Emergency detachment
Navy detachment
Hospital unit
Date June 18,1918.
Address Hiladelphia
Howards / amean M. D.
All- questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Local Committee on Red Cross Nursing Service.
Req. 17-14741-1M-May
(OVER)
Page data
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- Source index
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- Type
- photo
- Media ID
- ae88ab8aaac77f31
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Document data
- ID
- 2661385
- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "DMR29\nTHE AMERICAN RED CROSS\nsaRC\nE\nDEPARTMENT OF NURSING\n5-311-219-15\nPhysical Examination\n1. Name of applicant Florence me. Candlies Peter\nAddress 3334 Chestnul St City Peula\nState Penn\n2. Age\n35\nHeight\n64 1/4 Weight 153\n3. General physique\nGood - well developed\n4. Tendency to disease, inherited or otherwise none\n5.\nPrevious history in regard to serious illness or surgical operation negative\nno\n6. Has she had rheumatism ?\n7. Has she at present or has she ever had hernia?\nno\n8.\nCondition\nof\nteeth Good- none missing.\n9. Condition of feet slight flat feet no inconvenience\n10. Abdomen and contained organs\nnormal\n11. Chest and contained organs\nnormal\nGirth; expiration\n323/4\ninches; inspiration\n353/4 inches\nRespiration, rate of\n18\nHeart, pulse rate 74\nRight eye (Snellen) 20/30m ; corrected to 20/20 ; lens used\n12. Vision :\nLeft eye (Snellen) 20/20 ; corrected to 20/10/pthy ; lens used %502+9544960\nP.K. schwork\n13. Hearing: A. D 15/15\nA. S\n15/15\n14. Urine examination:\nColor Light ambre\nacid\nReaction\nSpecific gravity 1020\nAlbumen negative\nCasts none\nLeucocytes occasional\nSugar negative\n15. Do you recommend applicant for:\n(a) General hospital service yrs\nethe\n(b) Tropical service\nyrs.\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected :\nArmy base hospital\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nDate June 18,1918.\nAddress Hiladelphia\nHowards / amean M. D.\nAll- questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Local Committee on Red Cross Nursing Service.\nReq. 17-14741-1M-May\n(OVER)"
}