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DMR Form No. 30
DUPLICATE
THE GOOS
2063
W
HUMANITY
ASHINGTON
O
NURSING SERVICE
CERTIFICATE OF IMMUNITY
Place Brishol R.I.
Date June 9 , 1917
I certify that I have administered anti- typhoid vaccine as a prophylactie to
Miss margaret m. Canphey had Typhoid in the following doses: never
ist dose
c. c.
Date. may 1901
2nd dose
c. c.
Date
3rd dose
c. c.
Date
W Ined Williams MMM.D.
is satisfactorily protected by vaccination against smallpox.
I certify that Maryaret me Caughry
Paul appleten M.D.
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 Providence Rhock Island E.D.4. 43.
Navy detachment at
Hospital unit at
Surgical section at
This duplicate certificate should be forwarded by nurse to Chief Nurse of Unit or to Committee
Organizing Detachment.
Req. 17-478- -April-3000.
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"ocrText": "DMR Form No. 30\nDUPLICATE\nTHE GOOS\n2063\nW\nHUMANITY\nASHINGTON\nO\nNURSING SERVICE\nCERTIFICATE OF IMMUNITY\nPlace Brishol R.I.\nDate June 9 , 1917\nI certify that I have administered anti- typhoid vaccine as a prophylactie to\nMiss margaret m. Canphey had Typhoid in the following doses: never\nist dose\nc. c.\nDate. may 1901\n2nd dose\nc. c.\nDate\n3rd dose\nc. c.\nDate\nW Ined Williams MMM.D.\nis satisfactorily protected by vaccination against smallpox.\nI certify that Maryaret me Caughry\nPaul appleten M.D.\nFill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\nNaval base hospital at\nEmergency detachment at Providence Rhock Island E.D.4. 43.\nNavy detachment at\nHospital unit at\nSurgical section at\nThis duplicate certificate should be forwarded by nurse to Chief Nurse of Unit or to Committee\nOrganizing Detachment.\nReq. 17-478- -April-3000."
}