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D M R Form No. 29 THE CROSS NURSING SERVICE ASHINGTON HUMANIN DOCUMENT PHYSICAL EXAMINATION I. Name of applicant marguello Jacksbewer Address Grand City State Pa 2. Age 22 Height 5'9" Weight 130 3. General physique Good 4. Tendency to disease, inherited or otherwise m 5. Previous history in regard to serious illness or surgical operation now ( 6. Has she had rheumatism? no 7. Has she at present or has she ever had hernia? no 8. Condition of teeth Good 9. Condition of feet Good IO. Abdomen and contained organs Good II. Chest and contained organs Good Expiration 28 inches. Inspiration 3 / inches. I2. Vision : O. D 20/20. pph-50 aph+15oax.go Hearing: A. D 20/20 O. S. 20 / 20 pph. - A. S. 20/20 NOTE : In case of refractive error state degree of correction by glasses. I3. Urine examination: Color Straw Reaction ac Specific gravity 1017 Albumen no Casts now Leucocytes Sugar no 14. Do you recommend applicant for: (a) General hospital service you (b) Tropical service I5. Fill in location of base hospital, unit or detachment with which service is desired Army base hospital at Wrightsure N.J. Camp Mix Naval base hospital at Emergency detachment at for Navy detachment at Hospital unit at Surgical section at M. D. Date June 4- 18 Address 11f-w-8 Eii Pa 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. Req. 17-833-May-2cm

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    "ocrText": "D M R Form No. 29\nTHE CROSS\nNURSING SERVICE\nASHINGTON\nHUMANIN\nDOCUMENT\nPHYSICAL EXAMINATION\nI. Name of applicant marguello Jacksbewer\nAddress Grand\nCity\nState Pa\n2. Age 22\nHeight\n5'9\"\nWeight\n130\n3. General physique Good\n4. Tendency to disease, inherited or otherwise\nm\n5. Previous history in regard to serious illness or surgical operation\nnow\n(\n6. Has she had rheumatism? no\n7. Has she at present or has she ever had hernia?\nno\n8. Condition of teeth\nGood\n9. Condition of feet\nGood\nIO. Abdomen and contained organs Good\nII. Chest and contained organs Good\nExpiration\n28\ninches.\nInspiration\n3 /\ninches.\nI2. Vision : O. D 20/20. pph-50 aph+15oax.go Hearing: A. D 20/20\nO. S. 20 / 20 pph. -\nA. S.\n20/20\nNOTE : In case of refractive error state degree of correction by glasses.\nI3. Urine examination:\nColor\nStraw\nReaction\nac\nSpecific gravity 1017\nAlbumen no\nCasts\nnow\nLeucocytes\nSugar no\n14. Do you recommend applicant for:\n(a) General hospital service\nyou\n(b) Tropical service\nI5. Fill in location of base hospital, unit or detachment with which service is desired\nArmy base hospital at Wrightsure N.J. Camp Mix\nNaval base hospital at\nEmergency detachment at\nfor\nNavy detachment at\nHospital unit at\nSurgical section at\nM.\nD.\nDate June 4- 18\nAddress\n11f-w-8 Eii Pa\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.\nReq. 17-833-May-2cm"
}