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DMR Form No. 29 THE AMERICAN RED CROSS CENTRAL DIVISION HEADQUARTERS 180 NORTH WABASH AVENUE CHICAGO, ILL. NURSING SERVICE PHYSICAL EXAMINATION 1. Name of applicant Kathain Popke Address Marden City, State Man 2. Age 30 Height 5.7 Weight 200 3. General physique. Entra frod; how 4. Tendency to disease, inherited or otherwise 5. Previous history in regard to serious illness or surgical operation Hyphon free from yr he Ill effect ho. his other 6. Has she had meumatism? m no 7. Has she at present or has she ever had hernia? 8. Condition of teeth food. 9. Condition of feet very ford 10. Abdomen and contained organs how 11. Chest and contained organs hom Expiration 39 inches. Inspiration 43 inches. home 12. Vision O. D. Hearing: A. D. O. S flaps A. S human NOTE: In case of refractive error state degree of correction by glasses. 13. Urine examination: Color Light Reaction his Specific gravity 1018. Albumen now Casts home Leucocytes now Sugar. home 14. Do you recommend applicant for: (a) General hospital service. yo. (b) Tropical service OK 15. Fill in location of base hospital, unit or detachment with which service is desired: eite Army base hospital at Naval base hospital at Emergency detachment at Navy detachment at Hospital unit at Path Hard think Surgical section at M. D. che Date May 1-1 no Address Mondean Are 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. 17-833-1-3-18-20M

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    "ocrText": "DMR Form No. 29\nTHE AMERICAN RED CROSS\nCENTRAL DIVISION HEADQUARTERS\n180 NORTH WABASH AVENUE\nCHICAGO, ILL.\nNURSING SERVICE\nPHYSICAL EXAMINATION\n1. Name of applicant\nKathain Popke\nAddress Marden\nCity,\nState\nMan\n2. Age\n30\nHeight 5.7\nWeight\n200\n3. General physique.\nEntra frod;\nhow\n4. Tendency to disease, inherited or otherwise\n5. Previous history in regard to serious illness or surgical operation Hyphon free\nfrom yr he Ill effect ho. his other\n6. Has she had meumatism?\nm no\n7. Has she at present or has she ever had hernia?\n8. Condition of teeth\nfood.\n9. Condition of feet\nvery ford\n10. Abdomen and contained organs\nhow\n11. Chest and contained organs\nhom\nExpiration\n39\ninches.\nInspiration\n43\ninches.\nhome\n12. Vision O. D.\nHearing: A. D.\nO. S flaps\nA. S\nhuman\nNOTE: In case of refractive error state degree of correction by glasses.\n13. Urine examination:\nColor Light\nReaction\nhis\nSpecific gravity\n1018.\nAlbumen\nnow\nCasts\nhome\nLeucocytes\nnow\nSugar.\nhome\n14. Do you recommend applicant for:\n(a) General hospital service.\nyo.\n(b) Tropical service\nOK\n15. Fill in location of base hospital, unit or detachment with which service is desired:\neite\nArmy base hospital at\nNaval base hospital at\nEmergency detachment at\nNavy detachment at\nHospital unit at\nPath Hard think\nSurgical section at\nM. D.\nche\nDate May 1-1 no\nAddress\nMondean Are\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. 17-833-1-3-18-20M"
}