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Z
I
e
e
n
DMI2/UM
13. Abdomen: (condition of wall, scars, herniae, and abnormality of viscera) effection
sear firm
Circumference of abdomen at umbilicus 26
14. Nervous system: (note organic
or functional disorders) normal
Mrs.
15. Urinalysis: Sp. Gr. 1.028 Albumin none Sugar none Microscopical
<
Rare W.B.C.
16. Date of immunization against, Smallpox 1940
Typhoid 1940
17. Remarks on abnormalities not otherwise noted or sufficiently described on this blank:
L.
Is the applicant fit to perform active duty (Military, Disaster, etc.?) yes
M
If not, state type of duty she is physically fitted to perform
Samrell
Date Dec 3,1940
James E dance M.D Examiner
laurall ejor)
lanner
4
5
6
7
8
9
10
12
13
IS
se
Das ,01
n
17
18 19 20 21 22 23 24 25 26 27 28 29 30 31
32
Indicate missing teeth by "X", bridge work by
crowns by
plates by word
"plate".
esunim Teq
All questions MUST be answered; otherwise certificate will not be accepted at Head-
quarters. To be forwarded to the Local Committee on Red Cross Nursing Service.
1. Be sure that all items are filled in before forwarding. Make definite statements in all instances.
2. Give uge in years, height in inches, weight in pounds.
12. Chest measurements should be in total inches.
Docia
018
( TOVO)
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Context sent to Scholar
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