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D MR Form No. 29 AMERICAN REDUCTION NURSING SERVICE TH GOOSE 4 ASHINGTON HUMANIX D PHYSICAL EXAMINATION me Calla 34 8 52 - SaRe. McCulla, Alice R. I. Name of applicant Address 728 Kinan Street City. Honolulu State T.H. 40 2. Age Height 5 ft. 9 Weight 141 Good Double lobar 3. General physique pneumonia in 1912 4. Tendency to disease, inherited or otherwise None Rec. O.K. 5. Previous history in regard to serious illness or surgical operation No serious illness or surgical operation 6. Has she had rheumatism? No No 7. Has she at present or has she ever had hernia? 8. Condition of teeth O.K. 9. Condition of feet O.K. IO. Abdomen and contained organs O.K. II. Chest and contained organs Expiration 35 inches. Present weight - same Most ever weighed 141, May 16 1919 38 Inspiration inches. I2. Vision O. D /20 Hearing: A. D. Normal O. S /20 A. S. NOTE: In case of refractive error state degree of correction by glasses. 13. Urine examination: Color light yellow Reaction acid 1015 none Specific gravity Albumen Casts none Leucocytes none Sugar none 14. Do you recommend applicant for: (a) General hospital service What recommendation? - To be returned because of homesidiness and (b) Tropical service incompatibility. 15. 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 (Signed) S. M. Evserov M. D. Sept. 1919 Date Address Vladivostok Hospital 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": "D MR Form No. 29\nAMERICAN REDUCTION\nNURSING SERVICE\nTH\nGOOSE\n4\nASHINGTON\nHUMANIX\nD\nPHYSICAL EXAMINATION\nme Calla\n34 8 52 - SaRe.\nMcCulla, Alice R.\nI. Name of applicant\nAddress\n728 Kinan Street\nCity. Honolulu\nState\nT.H.\n40\n2. Age\nHeight 5 ft. 9\nWeight\n141\nGood\nDouble lobar\n3. General physique\npneumonia in 1912\n4. Tendency to disease, inherited or otherwise\nNone\nRec. O.K.\n5. Previous history in regard to serious illness or surgical operation No serious illness or surgical\noperation\n6. Has she had rheumatism?\nNo\nNo\n7. Has she at present or has she ever had hernia?\n8. Condition of teeth\nO.K.\n9. Condition of feet\nO.K.\nIO. Abdomen and contained organs\nO.K.\nII. Chest and contained organs\nExpiration 35\ninches.\nPresent weight - same\nMost ever weighed 141, May 16 1919\n38\nInspiration\ninches.\nI2. Vision O. D\n/20\nHearing: A. D.\nNormal\nO. S\n/20\nA. S.\nNOTE: In case of refractive error state degree of correction by glasses.\n13. Urine examination:\nColor\nlight yellow\nReaction\nacid\n1015\nnone\nSpecific gravity\nAlbumen\nCasts\nnone\nLeucocytes\nnone\nSugar\nnone\n14. Do you recommend applicant for:\n(a) General hospital service\nWhat recommendation? - To be returned\nbecause of homesidiness and\n(b) Tropical service\nincompatibility.\n15. 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\n(Signed) S. M. Evserov\nM. D.\nSept. 1919\nDate\nAddress\nVladivostok Hospital\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"
}