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I
5
es,
M
1
7
+
x
D M R SO DUPLICATE
N
e
American Red Cross
la
-
NURSING SERVICE
e
CERTIFICATE OF IMMUNITY
# 215825aRct
Place
Date ect/018
new yarticy
I certify that I have administered anti typhoid vaccine as a prophylactic to
mis nanner mith oline
in the following doses:
1st.dose
/
c. c.
Date sept io 18
2nd dose
/
c. c.
Date Selft 21 18
3rd dose
/
c. c.
Date Get. / 18
M. D.
I certify that
Miss nouau myrth obvin
is satisfactorily protected by vaccination against smallpox.
nonstriputure M.
D.
Fill in location of Base Hospital, Unit or Detachment with which service is desired:
Army Base Hospital at
Naval Base Hospital at
Emergency Detachment at
Navy Detachment at
Hospital Unit at
Surgical Section at
This duplicate certificate should be forwarded by nurse to Chief Nurse of Unit or to Com-
mittee Organizing Detachment.
2
W
8
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