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3
THE AMERICAN RED CROSS
DEPARTMENT OF NURSING
e
Physical Examination
1
1. Name of applicant
Marian Mescroll
O
=
-
Address 307 lecultral an City Cluange State A.J
26
Height
5-8
2. Age
Weight 144
3. General physique
Gord
3
4. Tendency to disease, inherited or otherwise
nme
ar
5. Previous history in regard to serious illness or surgical operation
nure
an
6. Has she had rheumatism?
no
Has she at or has she ever had hernia ?
8. 7. Condition of present teeth great no
a
9. Condition of feet
gnd
B
+
10. Abdomen and contained organs
0114
good
5
11. Chest and contained organs
Girth; expiration
31
inches; inspiration
34
inches
5
20
84
e
Respiration, rate of
Heart, pulse rate
Right eye (Snellen) 20/15
; corrected
to 20/15 ; lens used +508=t25as90
12. Vision :
Left eye (Snellen) 20/15 ; corrected to 20/15 ; lens used +1.008:-550-90
13. Hearing: A. D.
15/15
A. S. 15/15
14. Urine examination
Color mediune yellow
Reaction
acid
Specific gravity 1015
Albumen negative
Casts none
Leucocytes negative -
Sugar negative
15. Do you recommend applicant for:
(a) General hospital service
yes
(b) Tropical service
-
16.
Fill in name and number of base hospital, unit or detachment with which applicant is connected:
Army base hospital
riner
Naval base hospital
never
Emergency detachment
new
Navy detachment
name
I
Hospital unit
March
M. D.
aft 28 1925
leleasler buy Mulths
u
Date
Address 122 Pach are Eact Clarge
All questions MUST be answered; otherwise certificate will not be accepted at head-
not
quarters.
To be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross
Nursing Service.
(SEE OTHER SIDE)
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Document data
- ID
- 2661965
- Core
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- Type
- document
DTO data
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"ocrText": "3\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\ne\nPhysical Examination\n1\n1. Name of applicant\nMarian Mescroll\nO\n=\n-\nAddress 307 lecultral an City Cluange State A.J\n26\nHeight\n5-8\n2. Age\nWeight 144\n3. General physique\nGord\n3\n4. Tendency to disease, inherited or otherwise\nnme\nar\n5. Previous history in regard to serious illness or surgical operation\nnure\nan\n6. Has she had rheumatism?\nno\nHas she at or has she ever had hernia ?\n8. 7. Condition of present teeth great no\na\n9. Condition of feet\ngnd\nB\n+\n10. Abdomen and contained organs\n0114\ngood\n5\n11. Chest and contained organs\nGirth; expiration\n31\ninches; inspiration\n34\ninches\n5\n20\n84\ne\nRespiration, rate of\nHeart, pulse rate\nRight eye (Snellen) 20/15\n; corrected\nto 20/15 ; lens used +508=t25as90\n12. Vision :\nLeft eye (Snellen) 20/15 ; corrected to 20/15 ; lens used +1.008:-550-90\n13. Hearing: A. D.\n15/15\nA. S. 15/15\n14. Urine examination\nColor mediune yellow\nReaction\nacid\nSpecific gravity 1015\nAlbumen negative\nCasts none\nLeucocytes negative -\nSugar negative\n15. Do you recommend applicant for:\n(a) General hospital service\nyes\n(b) Tropical service\n-\n16.\nFill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital\nriner\nNaval base hospital\nnever\nEmergency detachment\nnew\nNavy detachment\nname\nI\nHospital unit\nMarch\nM. D.\naft 28 1925\nleleasler buy Mulths\nu\nDate\nAddress 122 Pach are Eact Clarge\nAll questions MUST be answered; otherwise certificate will not be accepted at head-\nnot\nquarters.\nTo be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross\nNursing Service.\n(SEE OTHER SIDE)"
}