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D M R 29
THE AMERICAN RED CROSS
NURSING SERVICE
Physical Examination
Carolina H. Kidd
I. Name of applicant
Address manetta
City
State Ohio
2. Age 44
Height 5th in
Weight 14
3.
General physique Ench- will muscular
4. Tendency to disease, inherited or otherwise done
5. Previous history in regard to serious illness or surgical operation for
overiou cypt. 1911- Ricorry coughte
6. Has she had rheumatism? no
7. Has she at present or has she ever had hernia?
no
9. Condition of feet good - normal
8. Condition of teeth Refairal Bridges and fillings
IO. Abdomen and contained organs normal
II. Chest and contained organs normal
Girth; expiration 38
inches; inspiration 41.
inches
Respiration, rate of 18
Heart, pulse rate 72
12. Vision:
{
Right eye (Snellen) To ; corrected to + 120 ; lens used for reading
Left eye (Snellen) n/no ; corrected to +250 lens used. providing
13. Hearing: A. D 20-20
A. S. 10-20
14. Urine examination:
Color ambur
Reaction acid
Specific gravity 1018
Albumen no
Casts nour
Leucocytes no
Sugar mom
I5. Do you recommend applicant for:
OR
(a) General hospital service. you
(b) Tropical service yes
16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:
Army base hospital nour
Naval base hospital.
mour
Emergency detachment norn
Navy detachment
mom
Hospital unit.
none
M. D.
Date april 30 1918
1st Address
AIY questions MUST be answered; otherwise certificate will not be accepted at head=
quarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
Req. 17-2125B-20M-Nov.
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"ocrText": "D M R 29\nTHE AMERICAN RED CROSS\nNURSING SERVICE\nPhysical Examination\nCarolina H. Kidd\nI. Name of applicant\nAddress manetta\nCity\nState Ohio\n2. Age 44\nHeight 5th in\nWeight 14\n3.\nGeneral physique Ench- will muscular\n4. Tendency to disease, inherited or otherwise done\n5. Previous history in regard to serious illness or surgical operation for\noveriou cypt. 1911- Ricorry coughte\n6. Has she had rheumatism? no\n7. Has she at present or has she ever had hernia?\nno\n9. Condition of feet good - normal\n8. Condition of teeth Refairal Bridges and fillings\nIO. Abdomen and contained organs normal\nII. Chest and contained organs normal\nGirth; expiration 38\ninches; inspiration 41.\ninches\nRespiration, rate of 18\nHeart, pulse rate 72\n12. Vision:\n{\nRight eye (Snellen) To ; corrected to + 120 ; lens used for reading\nLeft eye (Snellen) n/no ; corrected to +250 lens used. providing\n13. Hearing: A. D 20-20\nA. S. 10-20\n14. Urine examination:\nColor ambur\nReaction acid\nSpecific gravity 1018\nAlbumen no\nCasts nour\nLeucocytes no\nSugar mom\nI5. Do you recommend applicant for:\nOR\n(a) General hospital service. you\n(b) Tropical service yes\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital nour\nNaval base hospital.\nmour\nEmergency detachment norn\nNavy detachment\nmom\nHospital unit.\nnone\nM. D.\nDate april 30 1918\n1st Address\nAIY questions MUST be answered; otherwise certificate will not be accepted at head=\nquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-2125B-20M-Nov."
}