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C
B
1
B. If a wife, is she now pregnant?
B
XI. Has the applicant ever had-
XI.
A. Rheumatism, acute or chronic?
A
no.
B. Malaria?
B
no
C. Other fever?
C.
us.
D. Any disease or injury not included in pre-
D
no
vil
ceding questions?
a
ed al a
XII. Has the applicant noticed any recent marked
XII.
no.
gain or loss in flesh?
sievisos lo a
E
XIII. Would you recommend the applicant to a
XIII.
yes.
a
reputable Life Insurance Company as a
prudent risk?
+
XIV. Do you professionally consider the applicant
XIV.
yes.
5
a suitable person, physically, for appoint-
ment to overseas work
lo
XV. Would a tropical climate be likely to induce
XV.
no.
disease or cause disablement?
one THIS
XVI. Are there any facts known to you, or dis-
XVI. wome.
covered by you, not brought out in the
vil berrimezo so bluoda volli suiti
above questions, affecting or likely to af-
fect the health of the applicant? If so,
please state them.
XVII. Is there, in general, a soundness of constitu-
XVII.
yes.
they
tion and a vigor of health which give rea-
sonable probability that the applicant can
endure the physical and mental strain of
gromo
overseas work?
XVIII. When was the applicant last successfully
XVIII. East time 1921 was
vaccinated?
also unsuccessful in 1918 + 1919
XIX. Has the applicant had typhoid fever or the
anti-typhoid inoculation?
XIX,
yes.
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, ap proved 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.
Signature of Medical Examiner
Herman
M. D.
Address
124 Waterman St., Previdence, R.1.
6
5
4
Page data
- Page
- 88
- Source index
- 0
- Type
- photo
- Media ID
- 3a331e44dbe39b71
- Size
- unknown
Document data
- ID
- 2661393
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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"ocrText": "C\nB\n1\nB. If a wife, is she now pregnant?\nB\nXI. Has the applicant ever had-\nXI.\nA. Rheumatism, acute or chronic?\nA\nno.\nB. Malaria?\nB\nno\nC. Other fever?\nC.\nus.\nD. Any disease or injury not included in pre-\nD\nno\nvil\nceding questions?\na\ned al a\nXII. Has the applicant noticed any recent marked\nXII.\nno.\ngain or loss in flesh?\nsievisos lo a\nE\nXIII. Would you recommend the applicant to a\nXIII.\nyes.\na\nreputable Life Insurance Company as a\nprudent risk?\n+\nXIV. Do you professionally consider the applicant\nXIV.\nyes.\n5\na suitable person, physically, for appoint-\nment to overseas work\nlo\nXV. Would a tropical climate be likely to induce\nXV.\nno.\ndisease or cause disablement?\none THIS\nXVI. Are there any facts known to you, or dis-\nXVI. wome.\ncovered by you, not brought out in the\nvil berrimezo so bluoda volli suiti\nabove questions, affecting or likely to af-\nfect the health of the applicant? If so,\nplease state them.\nXVII. Is there, in general, a soundness of constitu-\nXVII.\nyes.\nthey\ntion and a vigor of health which give rea-\nsonable probability that the applicant can\nendure the physical and mental strain of\ngromo\noverseas work?\nXVIII. When was the applicant last successfully\nXVIII. East time 1921 was\nvaccinated?\nalso unsuccessful in 1918 + 1919\nXIX. Has the applicant had typhoid fever or the\nanti-typhoid inoculation?\nXIX,\nyes.\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, ap proved 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.\nSignature of Medical Examiner\nHerman\nM. D.\nAddress\n124 Waterman St., Previdence, R.1.\n6\n5\n4"
}