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DMR 29--N.E.D.
THE AMERICAN RED CROSS
DEPARTMENT OF NURSING
Physical Examination
1. Name of applicant
Florence E. Little
Address 36 Bandington It City Provision State R-J
2. Age 26.
Height
3. General physique Soon
6.3 1/2 wich Weight 121 no noclothing
4. Tendency to disease, inherited or otherwise
hour Known
5. Previous history in regard to serious illness or surgical operation Tonsitteeling
6. Has she had rheumatism?
no
7. Has she at present or has she ever had hernia?
ho
8. Condition of teeth
Very For Condition one birth mussing
9. Condition of feet
O.K
10. Abdomen and contained organs
Womes
11. Chest and contained organs
Normal
Girth; expiration
30 1/2
inches; inspiration 33 He
inches
Respiration, rate of 18
Heart, pulse rate 72
Right eye (Snellen) 10/18 20% corrected to 00/10
; lens used none
12. Vision:
2''0
Left eye (Snellen) 10/co 20/ corrected to
; lens used none
20
13. Hearing: A. D. Friez watch 15/15 wh goe
A. S.
Waler at Jones
mind 16/15
14. Urine examination:
Color phone
Reaction acid
Specific gravity 1029
Albumen name
Casts none
Leucocytes
"
Sugar have
B
15. Do you recommend applicant for:
(a) General hospital service
you
(b) Tropical service
16. Fill in name and number of base hospital, unit or detachment with which applicant is con-
nected:
Army base hospital
not commeted with any
Naval base hospital
Emergency detachment
Navy detachment
Hospital unit
Abut 3. Nayes
M. D.
Date
July 28/24
Address 198 Broad st Province
All questions MUST be answered; otherwise certificate will not be accepted
at headquarters.
To be forwarded to Chief Nurse of Unit or to the Local Committee Organizing
Detachment on Red Cross Nursing Service.
(SEE OTHER SIDE)
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Document data
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- Core
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- Type
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DTO data
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"ocrText": "DMR 29--N.E.D.\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nPhysical Examination\n1. Name of applicant\nFlorence E. Little\nAddress 36 Bandington It City Provision State R-J\n2. Age 26.\nHeight\n3. General physique Soon\n6.3 1/2 wich Weight 121 no noclothing\n4. Tendency to disease, inherited or otherwise\nhour Known\n5. Previous history in regard to serious illness or surgical operation Tonsitteeling\n6. Has she had rheumatism?\nno\n7. Has she at present or has she ever had hernia?\nho\n8. Condition of teeth\nVery For Condition one birth mussing\n9. Condition of feet\nO.K\n10. Abdomen and contained organs\nWomes\n11. Chest and contained organs\nNormal\nGirth; expiration\n30 1/2\ninches; inspiration 33 He\ninches\nRespiration, rate of 18\nHeart, pulse rate 72\nRight eye (Snellen) 10/18 20% corrected to 00/10\n; lens used none\n12. Vision:\n2''0\nLeft eye (Snellen) 10/co 20/ corrected to\n; lens used none\n20\n13. Hearing: A. D. Friez watch 15/15 wh goe\nA. S.\nWaler at Jones\nmind 16/15\n14. Urine examination:\nColor phone\nReaction acid\nSpecific gravity 1029\nAlbumen name\nCasts none\nLeucocytes\n\"\nSugar have\nB\n15. Do you recommend applicant for:\n(a) General hospital service\nyou\n(b) Tropical service\n16. Fill in name and number of base hospital, unit or detachment with which applicant is con-\nnected:\nArmy base hospital\nnot commeted with any\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nAbut 3. Nayes\nM. D.\nDate\nJuly 28/24\nAddress 198 Broad st Province\nAll questions MUST be answered; otherwise certificate will not be accepted\nat headquarters.\nTo be forwarded to Chief Nurse of Unit or to the Local Committee Organizing\nDetachment on Red Cross Nursing Service.\n(SEE OTHER SIDE)"
}