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DMR Form No. 29 THE GROSS NURSING SERVICE ED 74 ASHINGTON HUMANITY PHYSICAL EXAMINATION 218 S. Caderell are Special Foreign Infant Service Welfare Work I. Name of applicant Department Grove. 20 - Address 1653 Pack M City Chicago's State elees 2. Age 24 3. General physique Good Height 5ft Hin Weight 124 4. Tendency disease, to inherited or otherwise name . 5. Previous history in regard to serious illness or surgical operation Appendix received during acahe assock mav. 3.1917 6. Has she had rheumatism? Eight year ajos slight? 7. Has she at present or has she ever had hernia? none 8. Condition of teeth Good 9. Condition of feet good IO. Abdomen and contained organs normal 11. Chest and contained organs normal Expiration 2 inches. Inspiration 33/4 inches. 2 gin measurements 12. Vision: O.D. 20/20 Hearing: A. D. normal O. S. 20, 20 A.S. normal NOTE : In case of refractive error state degree of correction by glasses. I3. Urine examination: Color. Pali straw Reaction acid Specific gravity 1020 Albumen negation Casts Nona Sugar negative Leucocytes afew 14. Do you recommend applicant for: OK (a) General hospital service. (b) Tropical service. no. I5. Fill in location of base hospital, unit or detachment with which service is desired: Army base hospital at Naval base hospital at Emergency detachment at Navy detachment at Hospital unit at Surgical section at Date Dex V-1917 M. D. Address 30 no mich Bod 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": "DMR Form No. 29\nTHE\nGROSS\nNURSING SERVICE\nED 74\nASHINGTON\nHUMANITY\nPHYSICAL EXAMINATION\n218 S. Caderell are\nSpecial Foreign Infant Service\nWelfare Work\nI. Name of applicant\nDepartment\nGrove. 20\n-\nAddress 1653 Pack M\nCity Chicago's State elees\n2. Age 24\n3. General\nphysique Good\nHeight 5ft Hin Weight 124\n4. Tendency disease,\nto inherited or otherwise name\n.\n5. Previous history in regard to serious illness or surgical operation Appendix\nreceived during acahe assock mav. 3.1917\n6. Has she had rheumatism? Eight year ajos slight?\n7. Has she at present or has she ever had hernia? none\n8. Condition of teeth Good\n9.\nCondition of feet good\nIO. Abdomen and contained organs normal\n11. Chest and contained organs normal\nExpiration\n2 inches.\nInspiration\n33/4 inches.\n2 gin measurements\n12. Vision: O.D.\n20/20\nHearing: A. D. normal\nO. S. 20, 20\nA.S. normal\nNOTE : In case of refractive error state degree of correction by glasses.\nI3. Urine examination:\nColor. Pali straw\nReaction acid\nSpecific gravity 1020\nAlbumen negation\nCasts Nona\nSugar negative\nLeucocytes afew\n14. Do you recommend applicant for:\nOK\n(a) General hospital service.\n(b) Tropical service. no.\nI5. Fill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\nNaval base hospital at\nEmergency detachment at\nNavy detachment at\nHospital unit at\nSurgical section at\nDate Dex V-1917\nM. D.\nAddress 30 no mich Bod\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"
}