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a c K Ella PD MADIR3MA D. Has the applicant ever suffered from any D no disease or functional derangement of the il - respiratory system? If yes, state particu- lars. tenimex3 IssibaM E 10 E. What is the chest circumference? E 40 1/2 nebition Upon full inspiration? 41112 Upon full expiration 37 1/2 F. III. The Circulatory System. A. What is the temperature of the body? (If III. A 986° over 99° in the mouth, try another day.) J. B. Give the rate and other qualities of the pulse. Record blood-pressure. B 68 regular, normal in quality 130 Syst 80 Diast C. Does it intermit, or become irregular or un- C no equal? D. Does physical examination reveal anything D no whatever abnormal in the conditions of the heart or blood vessels? E. Has the applicant ever suffered from any E no disease of the circulatory system If yes, describe. IV. The Nervous System. IV. Has there ever been or is there any disease or negative as to all functional derangement of the brain or other parts of the nervous system ? If yes, functional or other state particulars. Inquire particularly re- diseases disorders garding headaches, insomnia, nervous ex- haustion, chorea or epilepsy and insanity. V. The Digestive System. V. no Has the applicant any disease or functional de- rangement? A. Of the stomach? A no B. Of the intestines? B no C. Of the liver ? C no D. Has there been or is there any tendency to D no chronic constipation? E. To diarrhea? E no.

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    "ocrText": "a\nc\nK\nElla\nPD\nMADIR3MA\nD. Has the applicant ever suffered from any\nD no\ndisease or functional derangement of the\nil\n-\nrespiratory system? If yes, state particu-\nlars.\ntenimex3 IssibaM\nE\n10\nE. What is the chest circumference?\nE 40 1/2 nebition\nUpon full inspiration?\n41112\nUpon full expiration\n37 1/2\nF.\nIII. The Circulatory System.\nA. What is the temperature of the body? (If\nIII. A\n986°\nover 99° in the mouth, try another day.)\nJ.\nB. Give the rate and other qualities of the pulse.\nRecord blood-pressure.\nB 68 regular, normal in quality\n130 Syst 80 Diast\nC. Does it intermit, or become irregular or un-\nC no\nequal?\nD. Does physical examination reveal anything\nD no\nwhatever abnormal in the conditions of the\nheart or blood vessels?\nE. Has the applicant ever suffered from any\nE no\ndisease of the circulatory system If yes,\ndescribe.\nIV. The Nervous System.\nIV.\nHas there ever been or is there any disease or\nnegative as to all\nfunctional derangement of the brain or\nother parts of the nervous system ? If yes,\nfunctional or other\nstate particulars. Inquire particularly re-\ndiseases disorders\ngarding headaches, insomnia, nervous ex-\nhaustion, chorea or epilepsy and insanity.\nV. The Digestive System.\nV.\nno\nHas the applicant any disease or functional de-\nrangement?\nA. Of the stomach?\nA no\nB. Of the intestines?\nB no\nC. Of the liver ?\nC\nno\nD. Has there been or is there any tendency to\nD no\nchronic constipation?\nE. To diarrhea?\nE no."
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