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N
DM
THE AMERICAN RED CROSS
DEPARTMENT OF NURSING
+
on
Physical Examination
1.
Name of applicant
Wi
2. Age
Address 135
37 East 71
City
new ynk
State
helf.
3
Height
5. 9
Weight
154
3. General physique
Rabark
4. Tendency to disease, inherited or otherwise none
4
5. Previous history in regard to serious illness or surgical operation
6. Has she had rheumatism ?
7. at or ever
Has she present has she had hernia ? no. 4 seto of opposed molars. Good condition
8.
Condition of teeth 5 mobars missing. ii false. T bridge. many fillings
D
9. Condition of feet Arches good Halley Valgus, (very elight no symptom)
10. Abdomen and contained organs normal.
11. Chest and normal
contained organs
Girth ; expiration 30%
inches; inspiration
33%
inches
Respiration, rate of
Heart, pulse rate
Right eye (Snellen) 2020
corrected to
12. Vision :
; lens used 7
Left eye (Snellen) 2030
corrected to
; lens used
13. Hearing: A. D.
15/15
A. S.
15/15
14. Urine examination
Color
Amber, clear
Reaction
acid
Specific gravity
1020
Albumen
0
Casts
0
Leucocytes
-
Sugar
a
15. Do you recommend applicant for :
(a) General hospital service
yes
(b) Tropical service
you
W
16. Fill in name and number of base hospital, unit or detachment with which applicant is connected
:
Army base hospital
Naval base hospital
Emergency detachment
0
Navy detachment
Hospital unit
swest
M. D.
Date Deta
Address 4/ East 70 new
All questions MUST be answered; otherwise certificate will not be accepted at head.
quarters.
To be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross
Nursing Service.
(SEE OTHER SIDE)
Page data
- Page
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- Source index
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- Type
- photo
- Media ID
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- Size
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Document data
- ID
- 2662045
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "N\nDM\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\n+\non\nPhysical Examination\n1.\nName of applicant\nWi\n2. Age\nAddress 135\n37 East 71\nCity\nnew ynk\nState\nhelf.\n3\nHeight\n5. 9\nWeight\n154\n3. General physique\nRabark\n4. Tendency to disease, inherited or otherwise none\n4\n5. Previous history in regard to serious illness or surgical operation\n6. Has she had rheumatism ?\n7. at or ever\nHas she present has she had hernia ? no. 4 seto of opposed molars. Good condition\n8.\nCondition of teeth 5 mobars missing. ii false. T bridge. many fillings\nD\n9. Condition of feet Arches good Halley Valgus, (very elight no symptom)\n10. Abdomen and contained organs normal.\n11. Chest and normal\ncontained organs\nGirth ; expiration 30%\ninches; inspiration\n33%\ninches\nRespiration, rate of\nHeart, pulse rate\nRight eye (Snellen) 2020\ncorrected to\n12. Vision :\n; lens used 7\nLeft eye (Snellen) 2030\ncorrected to\n; lens used\n13. Hearing: A. D.\n15/15\nA. S.\n15/15\n14. Urine examination\nColor\nAmber, clear\nReaction\nacid\nSpecific gravity\n1020\nAlbumen\n0\nCasts\n0\nLeucocytes\n-\nSugar\na\n15. Do you recommend applicant for :\n(a) General hospital service\nyes\n(b) Tropical service\nyou\nW\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected\n:\nArmy base hospital\nNaval base hospital\nEmergency detachment\n0\nNavy detachment\nHospital unit\nswest\nM. D.\nDate Deta\nAddress 4/ East 70 new\nAll questions MUST be answered; otherwise certificate will not be accepted at head.\nquarters.\nTo be forwarded to Chief Nurse of Unit or to the Local Committee on Red Cross\nNursing Service.\n(SEE OTHER SIDE)"
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