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I Form 596 AMERICAN RED CROSS Baltunor and - (City and State in which examined) DIVISION. Dec 15 1923 add Confidential Report of Medical Examiner M Choclath m Hurlina T In the case of S Address Box 678 Richwond by Questions to be Answered by Examining Physician. Note I. 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 43 years B. Have you had previous acquaintance with the applicant? How long? B No a C. Have you treated him or her professionally C No For what disease or injury? 1 M D. Does the general appearance indicate vigor- D Vigorous ous, medium or delicate health? E. State weight. E 168 lbs Height. 5 ft 4 Figure. Heavy F. Is there any deformity or malformation ? F No G. What is the temperament, nervous or other- G Even wise? II. The Respiratory System. II. A yes A. Is the respiration full, easy and regulari State the number of respirations in a min- 16 per min ute. B. Is there any tendency to cough, expectora- B No tion or difficulty in breathing on C. Does the physical examination reveal any- C No thing whatever abnormal in the condition of the respiratory organs? If yes, explain fully and state your opinion as to its sig- nificance. 2 - J J 0

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    "ocrText": "I\nForm 596\nAMERICAN RED CROSS\nBaltunor and\n-\n(City and State in which examined)\nDIVISION.\nDec 15\n1923\nadd\nConfidential Report of Medical Examiner\nM\nChoclath m Hurlina\nT\nIn the case of\nS\nAddress Box 678 Richwond by\nQuestions to be Answered by Examining Physician.\nNote I.\nPersonnel 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\nfor\nap-\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.\nThe 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.\nA 43 years\nB. Have you had previous acquaintance with the\napplicant? How long?\nB No\na\nC. Have you treated him or her professionally\nC No\nFor what disease or injury?\n1\nM\nD. Does the general appearance indicate vigor-\nD Vigorous\nous, medium or delicate health?\nE. State weight.\nE 168 lbs\nHeight.\n5 ft 4\nFigure.\nHeavy\nF. Is there any deformity or malformation ?\nF\nNo\nG. What is the temperament, nervous or other-\nG Even\nwise?\nII. The Respiratory System.\nII. A yes\nA. Is the respiration full, easy and regulari\nState the number of respirations in a min-\n16 per min\nute.\nB. Is there any tendency to cough, expectora-\nB No\ntion or difficulty in breathing\non\nC. Does the physical examination reveal any-\nC\nNo\nthing whatever abnormal in the condition\nof the respiratory organs? If yes, explain\nfully and state your opinion as to its sig-\nnificance.\n2\n-\nJ\nJ\n0"
}