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FINAL PHYSICAL EXAMINATION
HARVARD UNIT
FORM 1193
AMERICAN RED CROSS NURSING SERVICE
REV. 10-26-38
Rio 1/27/48
(areomly
PHYSICAL EXAMINATION
(Follow instructions at end of form in answering all questions)
Laurine Alva Smith
1. Name of applicant
Address Butheworth 1koop City Grand Rapids State much
2. Age
23
Height 62.5 m
Weight 142#
3. Family history
Essentially neg
4. Past history: General health, operation injury, any illnesses
Excellent
5. General physique
Hold Obesity
6. Eyes: Pupils; Right eye; Distant vision
Corrected to
Lens used
Left eye; Distant vision
Corrected to
Lens used
NOTE:-Actual vision should be determined on proper letters for 20 foot distant, as 20-20, 20-30, 20-100, etc.
If glasses are worn state correction.
7. Ears:
negative
8. Teeth and gums (note abnormalities) good condition
NOTE:-Check chart on other side of blank.
9. Throat defected Tousil on it sm. tag
10. Neck: (Thyroid
gland and other abnormalities) no adenopathy
Theyroid not pulpalpable
11. Skeletal: (Bones, joints, muscles and feet)
good physique
12. Thorax: Expiration
inches
Inspiration
inches
Respiration 20
per minute
Lungs to percussion and auscultation clas no rabs
Cardio-vascular system
good
Heart: Size
not enhad
Murmurs
no murmers
Pulse
70
Blood pressure: S 110
D
75
(Over)
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"ocrText": "FINAL PHYSICAL EXAMINATION\nHARVARD UNIT\nFORM 1193\nAMERICAN RED CROSS NURSING SERVICE\nREV. 10-26-38\nRio 1/27/48\n(areomly\nPHYSICAL EXAMINATION\n(Follow instructions at end of form in answering all questions)\nLaurine Alva Smith\n1. Name of applicant\nAddress Butheworth 1koop City Grand Rapids State much\n2. Age\n23\nHeight 62.5 m\nWeight 142#\n3. Family history\nEssentially neg\n4. Past history: General health, operation injury, any illnesses\nExcellent\n5. General physique\nHold Obesity\n6. Eyes: Pupils; Right eye; Distant vision\nCorrected to\nLens used\nLeft eye; Distant vision\nCorrected to\nLens used\nNOTE:-Actual vision should be determined on proper letters for 20 foot distant, as 20-20, 20-30, 20-100, etc.\nIf glasses are worn state correction.\n7. Ears:\nnegative\n8. Teeth and gums (note abnormalities) good condition\nNOTE:-Check chart on other side of blank.\n9. Throat defected Tousil on it sm. tag\n10. Neck: (Thyroid\ngland and other abnormalities) no adenopathy\nTheyroid not pulpalpable\n11. Skeletal: (Bones, joints, muscles and feet)\ngood physique\n12. Thorax: Expiration\ninches\nInspiration\ninches\nRespiration 20\nper minute\nLungs to percussion and auscultation clas no rabs\nCardio-vascular system\ngood\nHeart: Size\nnot enhad\nMurmurs\nno murmers\nPulse\n70\nBlood pressure: S 110\nD\n75\n(Over)"
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