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M
Hawaii Unit - Please return to Mrs. Amick
Assistant to Director
Nursing Service Form 1460
Rev. April 1942
American Red Cross
Physical Examination Record
Name
Reba Elizabeth Mumma
Date of birthne 20, 1916
Age 26
Home Address: City - 2136 Fulton St., Toledo
State
OHIO
E
PAST HISTORY
Give history of previous illness and treatments (medical and surgical)
Catarrhal jaundice in 1937
No surgery
Epilepsy or convulsive seizures-nervous or mental disease None
Is there a history of tuberculosis in the family or among intimate associates? If so, state particulars. None
PHYSICAL EXAMINATION
Ideal Wt.
Pulse
82
Temperature 98.4
Ht.
Wt. 198
for Ht.
140
General appearance well nourished
Physique well proportioned
Nutrition
excellent
Skin and mucous membranes
clear
Vision :
(Rt. eye
20 /20)
(Rt.
Without glasses
With glasses
/20)
(Lt. eye
15 /20)
(Lt.
/20)
Evidence of disease:
None
Hearing:
(Rt. ear
15/15)
Evidence of disease
(Rt. None
(Whispered voice)
(Lt. ear
15/15)
(Lt. None
I
D
Teeth Excellent
Gums
Not infected
Artificial dentures none
Nose and throat
Nose normal
Tonsils present
a
Lymph glands
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"ocrText": "M\nHawaii Unit - Please return to Mrs. Amick\nAssistant to Director\nNursing Service Form 1460\nRev. April 1942\nAmerican Red Cross\nPhysical Examination Record\nName\nReba Elizabeth Mumma\nDate of birthne 20, 1916\nAge 26\nHome Address: City - 2136 Fulton St., Toledo\nState\nOHIO\nE\nPAST HISTORY\nGive history of previous illness and treatments (medical and surgical)\nCatarrhal jaundice in 1937\nNo surgery\nEpilepsy or convulsive seizures-nervous or mental disease None\nIs there a history of tuberculosis in the family or among intimate associates? If so, state particulars. None\nPHYSICAL EXAMINATION\nIdeal Wt.\nPulse\n82\nTemperature 98.4\nHt.\nWt. 198\nfor Ht.\n140\nGeneral appearance well nourished\nPhysique well proportioned\nNutrition\nexcellent\nSkin and mucous membranes\nclear\nVision :\n(Rt. eye\n20 /20)\n(Rt.\nWithout glasses\nWith glasses\n/20)\n(Lt. eye\n15 /20)\n(Lt.\n/20)\nEvidence of disease:\nNone\nHearing:\n(Rt. ear\n15/15)\nEvidence of disease\n(Rt. None\n(Whispered voice)\n(Lt. ear\n15/15)\n(Lt. None\nI\nD\nTeeth Excellent\nGums\nNot infected\nArtificial dentures none\nNose and throat\nNose normal\nTonsils present\na\nLymph glands"
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