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P
e
-c
Form 596
Mr
L
AMERICAN RED CROSS
AUG 30 1918
-
Missoula, Montana
(City and State in which examined)
NORTHERN
DIVISION.
19
+to
O
L
Confidential Report of Medical Examiner
In the case
of Ann Forbes Reid
a
Address N. P. Hospital, Missoula, Montana.
Questions to be Answered by Examining Physician.
Note 1. Personnel in the foreign service of the American Red Cross often live and work in such trying incident climates, to amid loneliness such
such malignant diseases, and under such a nervous strain
pointment. insanitary and expatriation, surroundings, It is therefore that only exposed men expected and to women that the of Medical sound constitution Examiner will and make vigorous the examination health his statements should thorough be great recommended and reliance circumstantial for will ap- be
placed and that by he the will American feel Red Cross. Every question should be answered as omissions will necessitate correspondence
the
responsibility
of
his
office,
bearing
in
mind
that
upon
2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases
as to the reasons.
Note
under each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability
of its recurrence in the less favorable conditions under which the applicant is to work.
I. A. What is the applicant's age?
I. A 26 grt
A
B. Have you had previous acquaintance with the
applicant? How long?
B. yrs. 2 yrs.
und
C. Have you treated him or her professionally ?
C no.
For what disease or injury?
D. Does the general appearance indicate vigor-
D yes.
Medical Advisor,
Nor. Divos A.R.C.
ous, medium or delicate health?
E
131
E. State weight.
Height.
5 ft , inch
normal.
Figure.
F. Is there any deformity or malformation ?
F no
G. What is the temperament, nervous or other-
G Caleu
wise?
II. The Respiratory System.
A. Is the respiration full, easy and regular? State
II. A yrs.
the number of respirations in a minute.
B. Is there any tendency to cough, expectoration
B no.
or difficulty in breathing?
andi 10 A
C. Does the physical examination reveal anything
C. no
edi
whatever abnormal in the condition of the
respiratory organs? If yes, explain fully
and 10.0
a
and state your opinion as to its significance.
of ans atada ai 10 usod stadi a
of
binordo
of
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Document data
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- Core
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- Type
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DTO data
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"ocrText": "P\ne\n-c\nForm 596\nMr\nL\nAMERICAN RED CROSS\nAUG 30 1918\n-\nMissoula, Montana\n(City and State in which examined)\nNORTHERN\nDIVISION.\n19\n+to\nO\nL\nConfidential Report of Medical Examiner\nIn the case\nof Ann Forbes Reid\na\nAddress N. P. Hospital, Missoula, Montana.\nQuestions to be Answered by Examining Physician.\nNote 1. Personnel in the foreign service of the American Red Cross often live and work in such trying incident climates, to amid loneliness such\nsuch malignant diseases, and under such a nervous strain\npointment. insanitary and expatriation, surroundings, It is therefore that only exposed men expected and to women that the of Medical sound constitution Examiner will and make vigorous the examination health his statements should thorough be great recommended and reliance circumstantial for will ap- be\nplaced and that by he the will American feel Red Cross. Every question should be answered as omissions will necessitate correspondence\nthe\nresponsibility\nof\nhis\noffice,\nbearing\nin\nmind\nthat\nupon\n2. The examiner will please ask questions calculated to bring out the various symptoms pointing to the several diseases\nas to the reasons.\nNote\nunder each head, fully state any injurious effects of previous illness or injury and give an opinion as to the probability\nof its recurrence in the less favorable conditions under which the applicant is to work.\nI. A. What is the applicant's age?\nI. A 26 grt\nA\nB. Have you had previous acquaintance with the\napplicant? How long?\nB. yrs. 2 yrs.\nund\nC. Have you treated him or her professionally ?\nC no.\nFor what disease or injury?\nD. Does the general appearance indicate vigor-\nD yes.\nMedical Advisor,\nNor. Divos A.R.C.\nous, medium or delicate health?\nE\n131\nE. State weight.\nHeight.\n5 ft , inch\nnormal.\nFigure.\nF. Is there any deformity or malformation ?\nF no\nG. What is the temperament, nervous or other-\nG Caleu\nwise?\nII. The Respiratory System.\nA. Is the respiration full, easy and regular? State\nII. A yrs.\nthe number of respirations in a minute.\nB. Is there any tendency to cough, expectoration\nB no.\nor difficulty in breathing?\nandi 10 A\nC. Does the physical examination reveal anything\nC. no\nedi\nwhatever abnormal in the condition of the\nrespiratory organs? If yes, explain fully\nand 10.0\na\nand state your opinion as to its significance.\nof ans atada ai 10 usod stadi a\nof\nbinordo\nof"
}