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F. Has the applicant ever had any of the diseases F no of the digestive system? If yes, describe. Inquire particularly regarding appendicitis. VI. The Genito-Urinary System. VI. A. The specific gravity and reaction of the urine? A leid 1020 people B. Is any albumen present, by heat and acid, or B No by Heller's test? Both tests required. as C. Is any sugar present by Fehling's tests or by C us fermentation? all D. Results of microscopic analysis, if necessary. D negative E. Is there any derangement of the bladder? E. Vo F no F. Of the kidneys? VII. The Cutaneous System. aets VII. Has there ever been or is there any disease or no functional derangement of the system? as VX soubai VIII. The Organs of Sense. VIII. A No most 17% A. The sight. Does the condition of the eyes indicate that they should be examined by a specialist? B. The hearing. Any discharge from ears? B no No C. Other senses. of C IX. Have there been any cases among the parents, IX. brothers or sisters of the applicant of: no A. Consumption? A monow in arple B. Insanity? B no No C. Is there any predisposition hereditary or ac- C quired, to gout, rheumatism, cancer, arterial XIX disease, diabetes, or nervous disorders, es- pecially headaches, insomnia, nervous ex- haustion, chorea or epilepsy? If yes, state TOM nature. X. A. If the applicant is a woman, is she now suf- X. A fering or has she ever suffered from uterine no or menstrual disorder. (It is desirable that particular attention be given to this inquiry as the climate overseas bears heavily on those thus affected.) pit

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    "ocrText": "F. Has the applicant ever had any of the diseases\nF\nno\nof the digestive system? If yes, describe.\nInquire particularly regarding appendicitis.\nVI. The Genito-Urinary System.\nVI.\nA. The specific gravity and reaction of the urine?\nA\nleid 1020\npeople\nB. Is any albumen present, by heat and acid, or\nB\nNo\nby Heller's test? Both tests required.\nas\nC. Is any sugar present by Fehling's tests or by\nC\nus\nfermentation?\nall\nD. Results of microscopic analysis, if necessary.\nD negative\nE. Is there any derangement of the bladder?\nE.\nVo\nF\nno\nF. Of the kidneys?\nVII. The Cutaneous System. aets\nVII.\nHas there ever been or is there any disease or\nno\nfunctional derangement of the system?\nas\nVX\nsoubai\nVIII. The Organs of Sense.\nVIII.\nA No\nmost\n17%\nA. The sight. Does the condition of the eyes\nindicate that they should be examined by a\nspecialist?\nB. The hearing. Any discharge from ears?\nB no\nNo\nC. Other senses.\nof\nC\nIX. Have there been any cases among the parents,\nIX.\nbrothers or sisters of the applicant of:\nno\nA. Consumption?\nA\nmonow in arple\nB. Insanity?\nB\nno\nNo\nC. Is there any predisposition hereditary or ac-\nC\nquired, to gout, rheumatism, cancer, arterial\nXIX\ndisease, diabetes, or nervous disorders, es-\npecially headaches, insomnia, nervous ex-\nhaustion, chorea or epilepsy? If yes, state\nTOM\nnature.\nX. A. If the applicant is a woman, is she now suf-\nX. A\nfering or has she ever suffered from uterine\nno\nor menstrual disorder. (It is desirable that\nparticular attention be given to this inquiry\nas the climate overseas bears heavily on those\nthus affected.)\npit"
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