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D M R Form No. 29
of
NURSING SERVICE
THL E
574
PHYSICAL EXAMINATION
the
&
I. Name of applicant. This Bessir Thompson
Address City Hospital
City mineopoles State man
2. Age 33
Height
5-4 -
Weight 165
3. General physique
Rebust
4. Tendency to disease, inherited or otherwise none
5. Previous history in regard to serious illness or surgical operation oppendiclous
Jyphoid ago
6. Has she had rheumatism? none
7. Has she at present or has she ever had hernia? nowe
8. Condition of teeth
ok
9. Condition of feet ok
10. Abdomen and contained organs ok
II. Chest and contained organs ok
Expiration
29
inches.
Inspiration 33
inches.
I2. Vision: O.
Hearing: A. D.
20/20
O. S. 22/20
A. S.
20/20
NOTE: In case of refractive error state degree of correction by glasses.
13. Urine examination:
Color yellow
Reaction and
Specific gravity 1018
Albumen neg
Casts. neg
Leucocytes Free
Sugar
hey
14. Do you recommend applicant for:
OK
(a) General hospital service. yes
CH
(b) Tropical service
yes for any Same
15. Fill in location of base hospital, unit or detachment with which service is desired:
Army base hospital at
Naval base hospital at
Emergency detachment at
Navy detachment at
Hospital unit at
Public Health at Unit.
Surgical section
M.
D.
Date 4/8/ 8.
Address 3349 Univologr
All questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
Req. 17-833-May-~20M
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Document data
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- Core
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- Type
- document
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Context sent to Scholar
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"ocrText": "D M R Form No. 29\nof\nNURSING SERVICE\nTHL E\n574\nPHYSICAL EXAMINATION\nthe\n&\nI. Name of applicant. This Bessir Thompson\nAddress City Hospital\nCity mineopoles State man\n2. Age 33\nHeight\n5-4 -\nWeight 165\n3. General physique\nRebust\n4. Tendency to disease, inherited or otherwise none\n5. Previous history in regard to serious illness or surgical operation oppendiclous\nJyphoid ago\n6. Has she had rheumatism? none\n7. Has she at present or has she ever had hernia? nowe\n8. Condition of teeth\nok\n9. Condition of feet ok\n10. Abdomen and contained organs ok\nII. Chest and contained organs ok\nExpiration\n29\ninches.\nInspiration 33\ninches.\nI2. Vision: O.\nHearing: A. D.\n20/20\nO. S. 22/20\nA. S.\n20/20\nNOTE: In case of refractive error state degree of correction by glasses.\n13. Urine examination:\nColor yellow\nReaction and\nSpecific gravity 1018\nAlbumen neg\nCasts. neg\nLeucocytes Free\nSugar\nhey\n14. Do you recommend applicant for:\nOK\n(a) General hospital service. yes\nCH\n(b) Tropical service\nyes for any Same\n15. Fill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\nNaval base hospital at\nEmergency detachment at\nNavy detachment at\nHospital unit at\nPublic Health at Unit.\nSurgical section\nM.\nD.\nDate 4/8/ 8.\nAddress 3349 Univologr\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-833-May-~20M"
}