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D M R Form No. 29
THE AMERICAN RED CROSS
CENTRAL DIVISION HEADQUARTERS
180 NORTH WABASH AVENUE
CHICAGO, ILL.
NURSING SERVICE
PHYSICAL EXAMINATION
E
1. Name of applicant
Edith Louetta Olam
a
Address 905- n-Frankers City myle State min
Height 5-4
+
2. Age 24
Weight 140
5
3. General physique
mind
4. Tendency to disease, inherited or otherwise
more
none
0
5. Previous history in regard to serious illness or surgical operation
e
6. Has she had rheumatism?
m
7. Has she at present or has she ever had hernia?
m
8. Condition of teeth
good
9. Condition of feet
good
10. Abdomen and contained organs
mae
11. Chest and contained organs
armal
Expiration
50
inches.
Inspiration
33 1/2
inches.
12. Vision: o. D. 20 /20
Hearing: A.
D. 15/15 normal
O.: S 20 /20
A. S.
15/15 Mount
NOTE: In case of refractive error state degree of correction by glasses.
13. Urine examination:
Color amber
Reaction
and
Specific gravity
1020
Albumen
more
Casts
more
Leucocytes
none
Sugar
mm
B
14. Do you recommend applicant for:
(a) General hospital service.
yes
(b) Tropical service
15. Fill in location of base hospital, unit or detachment with which service is desired:
Army base hospital at
3
Naval base hospital at
Emergency detachment at
of
Navy detachment at
9
Hospital unit at
5
Surgical section at
Date
7/13/22
Address M. D.
All questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
Req. 17-833-1-3-18-20M
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"ocrText": "0\nD M R Form No. 29\nTHE AMERICAN RED CROSS\nCENTRAL DIVISION HEADQUARTERS\n180 NORTH WABASH AVENUE\nCHICAGO, ILL.\nNURSING SERVICE\nPHYSICAL EXAMINATION\nE\n1. Name of applicant\nEdith Louetta Olam\na\nAddress 905- n-Frankers City myle State min\nHeight 5-4\n+\n2. Age 24\nWeight 140\n5\n3. General physique\nmind\n4. Tendency to disease, inherited or otherwise\nmore\nnone\n0\n5. Previous history in regard to serious illness or surgical operation\ne\n6. Has she had rheumatism?\nm\n7. Has she at present or has she ever had hernia?\nm\n8. Condition of teeth\ngood\n9. Condition of feet\ngood\n10. Abdomen and contained organs\nmae\n11. Chest and contained organs\narmal\nExpiration\n50\ninches.\nInspiration\n33 1/2\ninches.\n12. Vision: o. D. 20 /20\nHearing: A.\nD. 15/15 normal\nO.: S 20 /20\nA. S.\n15/15 Mount\nNOTE: In case of refractive error state degree of correction by glasses.\n13. Urine examination:\nColor amber\nReaction\nand\nSpecific gravity\n1020\nAlbumen\nmore\nCasts\nmore\nLeucocytes\nnone\nSugar\nmm\nB\n14. Do you recommend applicant for:\n(a) General hospital service.\nyes\n(b) Tropical service\n15. Fill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\n3\nNaval base hospital at\nEmergency detachment at\nof\nNavy detachment at\n9\nHospital unit at\n5\nSurgical section at\nDate\n7/13/22\nAddress M. D.\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-833-1-3-18-20M"
}