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D. Has the applicant ever suffered from any dis- D. ease or functional derangement of the re- no spiratory system ? If yes, state particulars. E. What is the chest circumference? E 35 Upon full inspiration? Upon full expiration? 3/ III. The Circulatory System. III. A 970 A. What is the temperature of the body ? (If over 99° in the mouth, try another day.) 80 B. Give the rate and other qualities of the pulse. B Record blood-pressure. 110-74 ( C. Does it intermit, or become irregular or un- C equal? no no D. Does physical examination reveal anything D whatever abnormal in the conditions of the heart or blood vessels? E. Has the applicant ever suffered from any dis- E ease of the circulatory system ? If yes, de- scribe. no IV. The Nervous System. IV. Has there ever been or is there any disease or functional derangement of the brain or other parts of the nervous system ? If yes, state no particulars. Inquire particularly regarding headaches, insomnia, nervous exhaustion, chorea or epilepsy and insanity. V. The Digestive System. V. Has the applicant any disease or functional de- rangement? A. Of the stomach ? n A B. Of the intestines M B C. Of the liver ? n C D. Has there been or is there any tendency to D chronic constipation ? E. To diarrhea? E n

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0
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Media ID
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Document identity
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Document source extras
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Page context
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    "ocrText": "D. Has the applicant ever suffered from any dis-\nD.\nease or functional derangement of the re-\nno\nspiratory system ? If yes, state particulars.\nE. What is the chest circumference?\nE\n35\nUpon full inspiration?\nUpon full expiration?\n3/\nIII. The Circulatory System.\nIII. A\n970\nA. What is the temperature of the body ? (If\nover 99° in the mouth, try another day.)\n80\nB. Give the rate and other qualities of the pulse.\nB\nRecord blood-pressure.\n110-74 (\nC. Does it intermit, or become irregular or un-\nC\nequal?\nno\nno\nD. Does physical examination reveal anything\nD\nwhatever abnormal in the conditions of the\nheart or blood vessels?\nE. Has the applicant ever suffered from any dis-\nE\nease of the circulatory system ? If yes, de-\nscribe.\nno\nIV. The Nervous System.\nIV.\nHas there ever been or is there any disease or\nfunctional derangement of the brain or other\nparts of the nervous system ? If yes, state\nno\nparticulars. Inquire particularly regarding\nheadaches, insomnia, nervous exhaustion,\nchorea or epilepsy and insanity.\nV. The Digestive System.\nV.\nHas the applicant any disease or functional de-\nrangement?\nA. Of the stomach ?\nn\nA\nB. Of the intestines\nM\nB\nC. Of the liver ?\nn\nC\nD. Has there been or is there any tendency to\nD\nchronic constipation ?\nE. To diarrhea?\nE\nn"
}