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20 DMR: 29 THE AMERICAN RED CROSS DEPARTMENT OF NURSING Physical Examination 1. Name of applicant Sara m. Sray Address 1564 crotona pnk E City newynl State my. 2. Age 32 Height 5-st 3 in Weight 122 in light cloth 3. General physique medium 4. Tendency disease, inherited or otherwise none Knower to 5. Previous history in regard to serious illness or surgical operation no serious illness cx aft appurciate not supportune - in aug. 1917 6. Has she had rheumatism? no 7. no Has she at present or has she ever had hernia? 8. Condition of teeth 4 lower incison + 2 lover came perfect- 9. Condition of feet Excellent 10. Abdomen and contained organs welleut Excellent 11. Chest and contained organs Girth; expiration 2812 inches; inspiration 32 inches Respiration, rate of 20 Heart, pulse rate so 20 20 12. Vision: { Right eye (Snellen) ; corrected to ; lens used 20 20 20 Left eye (Snellen) ; corrected to ; lens used +0.25d.am 90 20 15 13. Hearing: A. D. 30 iwhisha 20 feet A. S. 30 Whisper 20fut 30 30 14. Urine examination amber acid Color Reaction Specific gravity 1.028 Albumen none Casts none Leucocytes Few Sugar none 15. Do you recommend applicant for: (a) General hospital service My (b) Tropical service no 16. Fill in name and number of base hospital, unit or detachment with which applicant is connected: Army base hospital Naval base hospital Emergency detachment Navy detachment Hospital unit sommon Footo M. D. Date June 4 1918 Address 119 E 40 st my All questions MUST be answered; otherwise certificate will not be accepted at head- quarters. To be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross Nursing Service. (SEE OTHER SIDE)

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Context sent to Scholar

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        "day": 27,
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        "month": 1,
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Page context
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    "ocrText": "20\nDMR: 29\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nPhysical Examination\n1. Name of applicant\nSara m. Sray\nAddress 1564 crotona pnk E City newynl\nState my.\n2. Age 32\nHeight\n5-st 3 in Weight 122 in light cloth\n3. General physique\nmedium\n4. Tendency disease, inherited or otherwise none Knower\nto\n5. Previous history in regard to serious illness or surgical operation no serious illness\ncx aft appurciate not supportune - in aug. 1917\n6. Has she had rheumatism?\nno\n7. no\nHas she at present or has she ever had hernia?\n8. Condition of teeth 4 lower incison + 2 lover came perfect-\n9. Condition of feet\nExcellent\n10. Abdomen and contained organs welleut\nExcellent\n11. Chest and contained organs\nGirth; expiration\n2812\ninches; inspiration 32\ninches\nRespiration, rate of\n20\nHeart, pulse rate\nso\n20\n20\n12. Vision:\n{\nRight eye (Snellen)\n; corrected to\n; lens used\n20\n20\n20\nLeft eye (Snellen)\n; corrected to\n; lens used +0.25d.am 90\n20\n15\n13. Hearing: A. D. 30 iwhisha 20 feet\nA. S. 30 Whisper 20fut\n30\n30\n14. Urine examination\namber\nacid\nColor\nReaction\nSpecific gravity 1.028\nAlbumen\nnone\nCasts\nnone\nLeucocytes\nFew\nSugar\nnone\n15. Do you recommend applicant for:\n(a) General hospital service\nMy\n(b) Tropical service\nno\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nsommon Footo M.\nD.\nDate June 4 1918\nAddress\n119 E 40 st my\nAll questions MUST be answered; otherwise certificate will not be accepted at head-\nquarters.\nTo be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross\nNursing Service.\n(SEE OTHER SIDE)"
}