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D M R 29 THE AMERICAN RED CROSS NURSING SERVICE Physical Examination 1. Name of Address 583 M. Washington City Wichita State Rhus applicant Miss Monica Rudalfle Higgins 2. Age 3. General physique Lith and comsenlar 29 mrs Height. 5ft2in Weight 110 lbo 4. Tendency to disease, Previous history in regard to serious illness or surgical operation Had engaipsles 7 individual to any disease inherited or otherwise no lendoney hereditary 5. about age 8 16 6. Has she had rheumatism? Has had alight attacks only 7. Has she at present or has she ever had hernia? see C 8. Condition of teeth. Two left-lower molers bridged Condition some 9. Condition of feet cycellant condition 10. Abdomen and contained organs normal 11. Chest and contained organs normal Girth; expiration 29 inches; inspiration 33 inches Respiration, rate of 20 Right eye (Snellen) 20/100 ; corrected to 29/20 ; lens used - / Jh Heart, pulse rate 76 12. Vision: Left eye (Snellen) 29,00 ; corrected to 20/20 ; lens used -1 Sph 13. Hearing: A. D (20) A. S. 20/20. 14. Urine examination: Color. clas amber Reaction acid Specific gravity 1012 Albumen more OK Casts none Leucocytes none Sugar none 15. Do you recommend applicant for: (a) General hospital service Yes This applicant an affe- rinal no -X ray tealusi- cian (b) Tropical service 16. Fill in name and number of base hospital, unit or detachment with which applicant is connected: Army base hospital Yes, as an x lay technician Naval base hospital Emergency detachment Navy detachment Hospital unit Drowerham M. D. Date Address Widila Ransas All questions MUST be answered; otherwise certificate will not be accepted at headquarters. To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment. 4-18. M.

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Document source extras
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    "ocrText": "D M R 29\nTHE AMERICAN RED CROSS\nNURSING SERVICE\nPhysical Examination\n1. Name of\nAddress 583 M. Washington City Wichita State Rhus\napplicant Miss Monica Rudalfle Higgins\n2. Age\n3.\nGeneral\nphysique Lith and comsenlar\n29 mrs Height. 5ft2in Weight\n110 lbo\n4. Tendency to disease,\nPrevious history in regard to serious illness or surgical operation Had engaipsles\n7 individual to any disease\ninherited or otherwise no lendoney hereditary\n5.\nabout age 8 16\n6.\nHas she had rheumatism? Has had alight attacks only\n7. Has she at present or has she ever had hernia?\nsee\nC\n8. Condition of teeth. Two left-lower molers bridged Condition some\n9. Condition of feet cycellant condition\n10. Abdomen and contained organs normal\n11. Chest and contained organs normal\nGirth; expiration 29\ninches; inspiration 33\ninches\nRespiration, rate of 20\nRight eye (Snellen) 20/100 ; corrected to 29/20 ; lens used - / Jh\nHeart, pulse rate 76\n12. Vision:\nLeft eye (Snellen) 29,00 ; corrected to 20/20 ; lens used -1 Sph\n13. Hearing: A. D\n(20)\nA. S. 20/20.\n14. Urine examination:\nColor. clas amber\nReaction acid\nSpecific gravity 1012\nAlbumen\nmore\nOK\nCasts none\nLeucocytes\nnone\nSugar none\n15. Do you recommend applicant for:\n(a) General hospital\nservice Yes This applicant an affe-\nrinal no -X ray tealusi- cian\n(b) Tropical service\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital Yes, as an x lay technician\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nDrowerham M. D.\nDate\nAddress Widila Ransas\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\n4-18. M."
}