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N.B H no D)
D. M. R. FORM NO. 29
MERICAN RED
THL CROSS
AMERICAN RED CROSS NURSING SERVICE
WASHINGTON DO
PHYSICAL EXAMINATION
I.
Name of applicant Hazd 9 Brusper
Address
240 / Banchient R
2. Age 25
Height
3. General appearance. healthy engarous
s N I'm
Weight 152
4. Tendency to disease, inherited or otherwise
name
5. or
Previous history in regard to serious illness surgical operation none--sayst
typhoid Jenne - 13 no years ago.
6. (Have you had rheumatism?
7. Have you at present or have you ever had hernia?
no
8. Condition of teeth
good
9. Condition of feet
normal
IO. Abdomen and contained organs
normal
II. Chest and contained organs.
normal
Expiration 36
inches.
Inspiration
32
inches.
12. Vision: O.D.
normal
Hearing: A. D. normal
O.S.
"
A.S.
"
13. Urine examination:
Color
amber
Reaction
and
Specific gravity
1015
Albumen
no
Casts
no
Leucocytes
no
Sugar.
no
14. Remarks as to fitness of applicant for:
(a) General hospital service smith fix for service
(b) Tropical service.
for James
M.D.
Date Mar16-17
Address
dam Namited
To be forwarded to the Chairman National Committee on Nursing Service, American Red Cross,
Washington, D.C.
Q/U. A / study
REQ. 16-600-JULY-3M.
"mm
wineles
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"ocrText": "N.B H no D)\nD. M. R. FORM NO. 29\nMERICAN RED\nTHL CROSS\nAMERICAN RED CROSS NURSING SERVICE\nWASHINGTON DO\nPHYSICAL EXAMINATION\nI.\nName of applicant Hazd 9 Brusper\nAddress\n240 / Banchient R\n2. Age 25\nHeight\n3. General appearance. healthy engarous\ns N I'm\nWeight 152\n4. Tendency to disease, inherited or otherwise\nname\n5. or\nPrevious history in regard to serious illness surgical operation none--sayst\ntyphoid Jenne - 13 no years ago.\n6. (Have you had rheumatism?\n7. Have you at present or have you ever had hernia?\nno\n8. Condition of teeth\ngood\n9. Condition of feet\nnormal\nIO. Abdomen and contained organs\nnormal\nII. Chest and contained organs.\nnormal\nExpiration 36\ninches.\nInspiration\n32\ninches.\n12. Vision: O.D.\nnormal\nHearing: A. D. normal\nO.S.\n\"\nA.S.\n\"\n13. Urine examination:\nColor\namber\nReaction\nand\nSpecific gravity\n1015\nAlbumen\nno\nCasts\nno\nLeucocytes\nno\nSugar.\nno\n14. Remarks as to fitness of applicant for:\n(a) General hospital service smith fix for service\n(b) Tropical service.\nfor James\nM.D.\nDate Mar16-17\nAddress\ndam Namited\nTo be forwarded to the Chairman National Committee on Nursing Service, American Red Cross,\nWashington, D.C.\nQ/U. A / study\nREQ. 16-600-JULY-3M.\n\"mm\nwineles"
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