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I
D M R 29
THE AMERICAN RED CROSS
e.
DEPARTMENT OF NURSING
S
-
PHYSICAL EXAMINATION
6
I. Name of applicant Miss anna Clara Heisler Badge No
1
Address
Odessa, mo
City
State
2. Age
35
Height 65in Weight / 65
5
3. General physique Excellent
5
4. Tendency to disease, inherited or otherwise none
a
5. Previous history in regard to serious illness or surgical operation
none
no
C
6. Has she had rheumatism?
7. Has she at present or has she ever had hernia?
no
a
9. Condition of feet Good
8. Condition of teeth Goad
IO. Abdomen and contained organs normal
II. Chest and contained organs
Mormal
Girth: Expiration 35
inches. Inspiration
38 1/2
inches
Respiration, rate
of 18
Heart, pulse rate
76
Right eye (Snellen) 20/20 Corrected to
lens used
I2. Vision:
Left eve (Snellen 20/20 Corrected to
lens used
13. Hearing:
A. D 15-15
A. S. 15-15
14. Urine examination:
Color. amber
Reaction acid
Specific gravity 1020
Albumen none
Casts none
Leucocytes now
Sugar. none
15. Do you recommend applicant for:
(a) General hospital service
No go.
yes or any place she mushes
(b) Tropical service. yes
16. Fill in name and number of base hospital; unit or detachment with which applicant is connected
Army base hospitar none
Naval base hospital none
Emergency detachment none
Navy detachment none
Hospital unit
none
CON.Allen
M. D.
Date 3-14-21.
Address
Odesxa, mo.
All questions MUST be answered; otherwise certificate will not be accepted at headquarters.
1
To be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross Nursing Service.
Req. 18-65B-15M-Jan.
(OVER)
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"ocrText": "I\nD M R 29\nTHE AMERICAN RED CROSS\ne.\nDEPARTMENT OF NURSING\nS\n-\nPHYSICAL EXAMINATION\n6\nI. Name of applicant Miss anna Clara Heisler Badge No\n1\nAddress\nOdessa, mo\nCity\nState\n2. Age\n35\nHeight 65in Weight / 65\n5\n3. General physique Excellent\n5\n4. Tendency to disease, inherited or otherwise none\na\n5. Previous history in regard to serious illness or surgical operation\nnone\nno\nC\n6. Has she had rheumatism?\n7. Has she at present or has she ever had hernia?\nno\na\n9. Condition of feet Good\n8. Condition of teeth Goad\nIO. Abdomen and contained organs normal\nII. Chest and contained organs\nMormal\nGirth: Expiration 35\ninches. Inspiration\n38 1/2\ninches\nRespiration, rate\nof 18\nHeart, pulse rate\n76\nRight eye (Snellen) 20/20 Corrected to\nlens used\nI2. Vision:\nLeft eve (Snellen 20/20 Corrected to\nlens used\n13. Hearing:\nA. D 15-15\nA. S. 15-15\n14. Urine examination:\nColor. amber\nReaction acid\nSpecific gravity 1020\nAlbumen none\nCasts none\nLeucocytes now\nSugar. none\n15. Do you recommend applicant for:\n(a) General hospital service\nNo go.\nyes or any place she mushes\n(b) Tropical service. yes\n16. Fill in name and number of base hospital; unit or detachment with which applicant is connected\nArmy base hospitar none\nNaval base hospital none\nEmergency detachment none\nNavy detachment none\nHospital unit\nnone\nCON.Allen\nM. D.\nDate 3-14-21.\nAddress\nOdesxa, mo.\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\n1\nTo be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross Nursing Service.\nReq. 18-65B-15M-Jan.\n(OVER)"
}