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FORM 1193 AMERICAN RED CROSS NURSING SERVICE REV. 10-26-38 PHYSICAL EXAMINATION (Follow instructions at end of form in answering all questions) 1. Name of applicant gertunds Hughes Landmisser Address 19th swalara sh City Harrishing State Pa 2. Age 45. Height set 6 into Weight 152 lbs_ 3. Family history mthu dead cause unknam. Father luing well / Brother being well. 30grs. 4. Past history: General health, operation, injury, any illnesses general Health good. Hysterictomy 1938. Serius infection 1941 5. General physique good 100+ 25 x 80 6. Eyes: Pupils; Right eye; Distant vision 20/50 Corrected to Lens used Bifocal +75+50 15 Left eye; Distant vision 20/40 Corrected to N/A Lens used Bifocal. R. 20/15 L. 20/15. NOTE: - Actual vision should be determined on proper letters for 20 foot distant, as 20-20,20-30, 20-100, etc. If glasses are worn state correction. 7. Ears: Normal 8. Teeth and gums: (note abnormalities) good no false dentires- - taxing answer NOTE:-Check chart on other side of blank. 9. Throat 10. Neck: (Thyroid gland and other abnormalities) 11. Skeletal: (Bones, joints, muscles and feet) 12. Thorax: Expiration inches Inspiration inches Respiration per minute Lungs to percussion and auscultation Cardio-vascular system Heart: Size Murmurs Pulse Blood pressure: S D (Over)

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    "ocrText": "FORM 1193\nAMERICAN RED CROSS NURSING SERVICE\nREV. 10-26-38\nPHYSICAL EXAMINATION\n(Follow instructions at end of form in answering all questions)\n1. Name of applicant gertunds Hughes Landmisser\nAddress 19th swalara sh City Harrishing\nState Pa\n2. Age\n45.\nHeight\nset 6 into\nWeight 152 lbs_\n3. Family history mthu dead cause unknam. Father luing well / Brother being well.\n30grs.\n4. Past history: General health, operation, injury, any illnesses general Health good.\nHysterictomy 1938. Serius infection 1941\n5. General physique good\n100+ 25 x 80\n6. Eyes: Pupils; Right eye; Distant vision 20/50 Corrected to Lens used Bifocal\n+75+50 15\nLeft eye; Distant vision 20/40 Corrected to N/A Lens used Bifocal.\nR. 20/15\nL. 20/15.\nNOTE: - Actual vision should be determined on proper letters for 20 foot distant, as 20-20,20-30, 20-100, etc.\nIf glasses are worn state correction.\n7. Ears:\nNormal\n8. Teeth and gums: (note abnormalities) good no false dentires- -\ntaxing\nanswer\nNOTE:-Check chart on other side of blank.\n9. Throat\n10. Neck: (Thyroid gland and other abnormalities)\n11. Skeletal: (Bones, joints, muscles and feet)\n12. Thorax: Expiration\ninches\nInspiration\ninches\nRespiration\nper minute\nLungs to percussion and auscultation\nCardio-vascular system\nHeart: Size\nMurmurs\nPulse\nBlood pressure: S\nD\n(Over)"
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