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Form 596
AMERICAN RED CROSS
Waterloo Iowa
(City and State in which examined)
DIVISION.
Akril 8
1919
Confidential Report of Medical Examiner
In the case of
Mas Matheuno Topreed R.R.
Address 638 malmidd matherlow Towe
Questions to be Answered by Examining Physician.
Note 1. Personnel in the foreign service of the American Red Cross often live and work in such trying climates, amid such
insanitary surroundings, exposed to such malignant diseases, and under such a nervous strain incident to loneliness
and expatriation, that only men and women of sound constitution and vigorous health should be recommended for ap-
pointment. It is therefore expected that the Medical Examiner will make the examination thorough and circumstantial
and that he will feel the responsibility of his office, bearing in mind that upon his statements great reliance will be
placed by the American Red Cross. Every question should be answered as omissions will necessitate correspondence
as to the reasons.
Note 2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases
under each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability
of its recurrence in the less favorable conditions under which the applicant is to work.
I. A. What is the applicant's age?
I. A 29
B. Have you had previous acquaintance with the
applicant? How long?
B 6 years
her
(016)
C. Have you treated him or her professionally ?
C. no
For what disease or injury ?
D. Does the general appearance indicate vigor-
D
Vigerou Health
ous, medium or delicate health?
E. State weight.
E 210
Height.
3 - ft 6 in
Figure.
the front Should
F. Is there any deformity or malformation?
F. no
G. What is the temperament, nervous or other-
G actuarist
wise?
II. The Respiratory System.
II. A yes 18
A. Is the respiration full, easy and regular? State
the number of respirations in a minute.
B. Is there any tendency to cough, expectoration
BKO
or difficulty in breathing?
C. Does the physical examination reveal anything
C. no
whatever abnormal in the condition of the
respiratory organs? If yes, explain fully
and state your opinion as to its significance.
)
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Document data
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DTO data
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Context sent to Scholar
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"ocrText": "Form 596\nAMERICAN RED CROSS\nWaterloo Iowa\n(City and State in which examined)\nDIVISION.\nAkril 8\n1919\nConfidential Report of Medical Examiner\nIn the case of\nMas Matheuno Topreed R.R.\nAddress 638 malmidd matherlow Towe\nQuestions to be Answered by Examining Physician.\nNote 1. Personnel in the foreign service of the American Red Cross often live and work in such trying climates, amid such\ninsanitary surroundings, exposed to such malignant diseases, and under such a nervous strain incident to loneliness\nand expatriation, that only men and women of sound constitution and vigorous health should be recommended for ap-\npointment. It is therefore expected that the Medical Examiner will make the examination thorough and circumstantial\nand that he will feel the responsibility of his office, bearing in mind that upon his statements great reliance will be\nplaced by the American Red Cross. Every question should be answered as omissions will necessitate correspondence\nas to the reasons.\nNote 2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases\nunder each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability\nof its recurrence in the less favorable conditions under which the applicant is to work.\nI. A. What is the applicant's age?\nI. A 29\nB. Have you had previous acquaintance with the\napplicant? How long?\nB 6 years\nher\n(016)\nC. Have you treated him or her professionally ?\nC. no\nFor what disease or injury ?\nD. Does the general appearance indicate vigor-\nD\nVigerou Health\nous, medium or delicate health?\nE. State weight.\nE 210\nHeight.\n3 - ft 6 in\nFigure.\nthe front Should\nF. Is there any deformity or malformation?\nF. no\nG. What is the temperament, nervous or other-\nG actuarist\nwise?\nII. The Respiratory System.\nII. A yes 18\nA. Is the respiration full, easy and regular? State\nthe number of respirations in a minute.\nB. Is there any tendency to cough, expectoration\nBKO\nor difficulty in breathing?\nC. Does the physical examination reveal anything\nC. no\nwhatever abnormal in the condition of the\nrespiratory organs? If yes, explain fully\nand state your opinion as to its significance.\n)"
}