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I
+
M
Previous history in regard to serious illness or surgical
operation afferended
Any history of hernia?
no
Any history of rheumatism? no
Urine examination (only examine if indicated)
Nervous system nural
Any evidence of impaired health? more
norwal
Remarks as to fitness of applicant for visiting nursing
M. D.
Address 6,7 on.clark nd
Date. Seft 2. 1916
To be forwarded by the nurse with original certificate of immunity
against typhoid fever and small pox, to Superintendent, Town and
Country Nursing Service, American Red Cross, Washington, D. C.
5,
8
6
2
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- Core
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DTO data
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Context sent to Scholar
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Document source metadata
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Document source extras
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