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DMR 29
THE AMERICAN RED CROSS
NURSING SERVICE
Physical Examination
1. Name of applicant
Janephone N Jokaitiz
Address 769 32 Maryland City Mary State
and
2. Age
Height
Weight 133
3. General physique study
4. Tendency to disease, inherited or otherwise
"neg.
5.
Previous history in regard to serious illness or surgical operation sug
6. Has she had rheumatism ?
no
7. Has she at present or has she ever had hernia? no
8. Condition of teeth
on
9. Condition of feet
ok
10. Abdomen and contained organs OK
11. Chest and contained organs
ok
Girth; expiration
30 th
inches; inspiration 33 //
inches
Respiration, rate of
18
Heart, pulse rate 76
Right eye (Snellen) 20/10/00
; corrected to
; lens used
12. Vision:
{
Left eye (Snellen)
go
; corrected to
; lens used
13. Hearing: A. D.
201530
A. S.
2015
14. Urine examination:
Color
Reaction
Specific gravity
Albumen
Casts
Leucocytes
Sugar
15. Do you recommend applicant for:
(a) General hospital service. yes.
(b) Tropical service
16. Fill in name and number of base hospital, unit or detachment with which applicant is con-
nected: none.
Army base hospital
Naval base hospital
Emergency detachment
Navy detachment
Hospital unit
M. D.
Date
Address
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.
Page data
- Page
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- Source index
- 0
- Type
- photo
- Media ID
- 36405aea970b8789
- Size
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Document data
- ID
- 2661719
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "DMR 29\nTHE AMERICAN RED CROSS\nNURSING SERVICE\nPhysical Examination\n1. Name of applicant\nJanephone N Jokaitiz\nAddress 769 32 Maryland City Mary State\nand\n2. Age\nHeight\nWeight 133\n3. General physique study\n4. Tendency to disease, inherited or otherwise\n\"neg.\n5.\nPrevious history in regard to serious illness or surgical operation sug\n6. Has she had rheumatism ?\nno\n7. Has she at present or has she ever had hernia? no\n8. Condition of teeth\non\n9. Condition of feet\nok\n10. Abdomen and contained organs OK\n11. Chest and contained organs\nok\nGirth; expiration\n30 th\ninches; inspiration 33 //\ninches\nRespiration, rate of\n18\nHeart, pulse rate 76\nRight eye (Snellen) 20/10/00\n; corrected to\n; lens used\n12. Vision:\n{\nLeft eye (Snellen)\ngo\n; corrected to\n; lens used\n13. Hearing: A. D.\n201530\nA. S.\n2015\n14. Urine examination:\nColor\nReaction\nSpecific gravity\nAlbumen\nCasts\nLeucocytes\nSugar\n15. Do you recommend applicant for:\n(a) General hospital service. yes.\n(b) Tropical service\n16. Fill in name and number of base hospital, unit or detachment with which applicant is con-\nnected: none.\nArmy base hospital\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nM. D.\nDate\nAddress\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."
}