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Mrs. Florence M. ( H. C.) . Florence M. Peter RECEIV JUN 28 1918 AMERICAN RED CROSS 5311 NURSING SERVICE Physical Examination Blank AMERICAN RED CROSS 1-Be sure that all items are filled in before for- EPARTMENT OF NURSING warding. Take definite statements in all instances. Physical Examination 2-Give age in years, height in inches, weight OF in pounds, stating amount of clothing enter- ing into the weight. 8-State what teeth are missing, and existing dentistry, such as crowns, plates, etc , state number of opposed molars. 9-Flat foot-state whether or not any incon- venience exists. 11-Chest measurements should be in total inches. 12-Actual vision should be stated determined on proper letters for 20-foot distance, as 20/20, 20/50, 20/100. If glasses are worn state correction. Hearing should record whispered voices at 15 feet, 15/15, 10/15, etc.

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Document identity
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Document source extras
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Page context
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    "ocrText": "Mrs. Florence M. ( H. C.)\n.\nFlorence M. Peter\nRECEIV\nJUN 28 1918\nAMERICAN RED CROSS\n5311\nNURSING SERVICE\nPhysical Examination Blank\nAMERICAN RED CROSS\n1-Be sure that all items are filled in before for-\nEPARTMENT OF NURSING\nwarding. Take definite statements in all\ninstances.\nPhysical Examination\n2-Give age in years, height in inches, weight\nOF\nin pounds, stating amount of clothing enter-\ning into the weight.\n8-State what teeth are missing, and existing\ndentistry, such as crowns, plates, etc , state\nnumber of opposed molars.\n9-Flat foot-state whether or not any incon-\nvenience exists.\n11-Chest measurements should be in total\ninches.\n12-Actual vision should be stated determined\non proper letters for 20-foot distance, as\n20/20, 20/50, 20/100. If glasses are worn\nstate correction.\nHearing should record whispered voices at 15\nfeet, 15/15, 10/15, etc."
}