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D M R Form No.229 ZM NURSING SERVICE ere & - a C PHYSICAL EXAMINATION e 1 K Name of applicant Katharine Macklin 1. ath K a Address (50) 701 142 City my State my 2. Age 35- Height 62 inches 2 Weight 117 3. General physique. attractive + good , 4. Tendency to disease, inherited or otherwise none known 5. Previous history in regard to serious illness or surgical operation Jonsellectory in June 1917 no J. 6. Has she had rheumatism? 7. Has she at present or has she ever had hernia? no 8. Condition of teeth good lower right #7 out 9. Condition of feet IO. Chest Abdomen and and contained contained órgans good good II. organs Expiration 31 inches. Inspiration 3B'1 inches. I2. Vision: O. D. 242 Hearing: A. D. 20/20 O. S. W20 A. S. 3/120 NOTE: In case of refractive error state degree of correction by glasses 13. Urine examination: Color Reaction Specific gravity Albumen Casts. Rel attracted Hanewation Leucocytes Sugar refunded 14. Do you recommend applicant for: (a) General hospital service yes OK (b) Tropical service no the I5. Fill in location of base hospital, unit or detachment with which service is desired: Army base hospital at Naval base hospital at Emergency detachment at 60 Foreign Public Health 5 Navy detachment at 2 Hospital unit at J Surgical section at Eduin (Facily M. D. Date Address 210 WIID All questions MUST be answered; otherwise certificate will not be accepted at headquarters. To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment. Req. 17-833-May-2cM

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    "ocrText": "D M R Form No.229\nZM\nNURSING SERVICE\nere\n&\n-\na\nC\nPHYSICAL EXAMINATION\ne\n1\nK\nName of applicant Katharine Macklin\n1.\nath\nK\na\nAddress\n(50) 701 142 City my\nState my\n2. Age\n35-\nHeight 62 inches 2 Weight 117\n3. General physique.\nattractive\n+\ngood ,\n4. Tendency to disease, inherited or otherwise\nnone known\n5. Previous history in regard to serious illness or surgical operation Jonsellectory in\nJune 1917\nno\nJ.\n6. Has she had rheumatism?\n7. Has she at present or has she ever had hernia?\nno\n8. Condition of teeth\ngood lower right #7 out\n9. Condition of feet\nIO. Chest Abdomen and and contained contained órgans good\ngood\nII. organs\nExpiration\n31\ninches.\nInspiration\n3B'1\ninches.\nI2. Vision: O. D. 242\nHearing: A. D. 20/20\nO. S. W20\nA. S.\n3/120\nNOTE: In case of refractive error state degree of correction by glasses\n13. Urine examination:\nColor\nReaction\nSpecific gravity\nAlbumen\nCasts.\nRel attracted Hanewation\nLeucocytes\nSugar\nrefunded\n14. Do you recommend applicant for:\n(a) General hospital service yes\nOK\n(b) Tropical service\nno\nthe\nI5. Fill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\nNaval base hospital at\nEmergency detachment at 60 Foreign Public Health\n5\nNavy detachment at\n2\nHospital unit at\nJ\nSurgical section at\nEduin (Facily\nM. D.\nDate\nAddress 210 WIID\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-833-May-2cM"
}