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D. M. R. FORM.NO. 29
EDgn
E
AMERICAN RED CROSS NURSING SERVICE
4
PHYSICAL EXAMINATION
not in
I. Name of applicant Hiss Olivia Peterson
0
Address. Decoral Iowa.
2. Age. 27
L
3. General appearance good
Height s feet 9in Weight
140
a
4.
new
Tendency to disease, inherited or otherwise none know family
5. Previous history in regard to serious illness or surgical operation no serious Selness
Has had tonails removed.
6. Have you had rheumatism? no
7. Have you at present or have you ever had hernia? no
9. Condition of feet good
8. Condition of teeth good
IO. Abdomen and contained organs good
II.
Chest and contained organs good
Expiration
32
inches.
Inspiration
37
inches.
20
I2. Vision: O. D.
20
Hearing: A. D
normal
o. S.
29
20
A. S.
normal
I3. Urine examination:
Color
straw
Reaction
acid
Specific gravity 1020
Albumen none
Casts none
Leucocytes none
Sugar none
14. Remarks as to fitness of applicant for:
(a) General
hospital service. Very good
(b) Tropical service Borramdined 1 north
OK
Date Junex 4- 17
Smlianghal
M. D.
CHO.
Address Decorah Down
8
To be forwarded to the Chairman National Committee on Nursing Service, American Red Cross,
Washington, D. C.
of
Req. 17-109-Feb.-3000.
and
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"ocrText": "e\nD. M. R. FORM.NO. 29\nEDgn\nE\nAMERICAN RED CROSS NURSING SERVICE\n4\nPHYSICAL EXAMINATION\nnot in\nI. Name of applicant Hiss Olivia Peterson\n0\nAddress. Decoral Iowa.\n2. Age. 27\nL\n3. General appearance good\nHeight s feet 9in Weight\n140\na\n4.\nnew\nTendency to disease, inherited or otherwise none know family\n5. Previous history in regard to serious illness or surgical operation no serious Selness\nHas had tonails removed.\n6. Have you had rheumatism? no\n7. Have you at present or have you ever had hernia? no\n9. Condition of feet good\n8. Condition of teeth good\nIO. Abdomen and contained organs good\nII.\nChest and contained organs good\nExpiration\n32\ninches.\nInspiration\n37\ninches.\n20\nI2. Vision: O. D.\n20\nHearing: A. D\nnormal\no. S.\n29\n20\nA. S.\nnormal\nI3. Urine examination:\nColor\nstraw\nReaction\nacid\nSpecific gravity 1020\nAlbumen none\nCasts none\nLeucocytes none\nSugar none\n14. Remarks as to fitness of applicant for:\n(a) General\nhospital service. Very good\n(b) Tropical service Borramdined 1 north\nOK\nDate Junex 4- 17\nSmlianghal\nM. D.\nCHO.\nAddress Decorah Down\n8\nTo be forwarded to the Chairman National Committee on Nursing Service, American Red Cross,\nWashington, D. C.\nof\nReq. 17-109-Feb.-3000.\nand"
}