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D. M. R. FORM NO. 29
MERICANRIDE
THE GOOS
AMERICAN RED CROSS NURSING SERVICE
WASHINGTON DO
PHYSICAL EXAMINATION
I. Name of
applicant Laura Fone Knowlton
Address Vassalboro maine
2.
Age 30
Height 5/4 7 Weight 140
3. General appearance.
Execution wild developed
4. Tendency to disease, inherited or otherwise
no
5. Previous history in regard to serious illness or surgical operation Tonsilerly 1910
Oneumin 1909
6. Have you had rheumatism?
no
7. Have you at present or have you ever had hernia?
no
8. Condition of teeth
bood
9. Condition of feet
ok
IO. Abdomen and contained organs
OK
II. Chest and contained organs
OK
Expiration
33
inches.
Inspiration
36
inches.
12. Vision: O. D.
20/20
Hearing: A. D.
20/20
O.S.
20/20
A. S 20/20
I3. Urine examination:
Color
awby
Reaction
acid
1224
0
Specific gravity
Albumen
Casts
Dev
Leucocytes
Sugar
No
H
14. Remarks as to fitness of applicant for:
(a) General hospital service.
(b) Tropical service
M.D.
Date. may 7 1920
Address. neutomic Was
To be forwarded to the Chairman National Committee on Nursing Service, American Red Cross,
Washington, D.C.
REQ. 16-600-JULY-3M
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Context sent to Scholar
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"ocrText": "D. M. R. FORM NO. 29\nMERICANRIDE\nTHE GOOS\nAMERICAN RED CROSS NURSING SERVICE\nWASHINGTON DO\nPHYSICAL EXAMINATION\nI. Name of\napplicant Laura Fone Knowlton\nAddress Vassalboro maine\n2.\nAge 30\nHeight 5/4 7 Weight 140\n3. General appearance.\nExecution wild developed\n4. Tendency to disease, inherited or otherwise\nno\n5. Previous history in regard to serious illness or surgical operation Tonsilerly 1910\nOneumin 1909\n6. Have you had rheumatism?\nno\n7. Have you at present or have you ever had hernia?\nno\n8. Condition of teeth\nbood\n9. Condition of feet\nok\nIO. Abdomen and contained organs\nOK\nII. Chest and contained organs\nOK\nExpiration\n33\ninches.\nInspiration\n36\ninches.\n12. Vision: O. D.\n20/20\nHearing: A. D.\n20/20\nO.S.\n20/20\nA. S 20/20\nI3. Urine examination:\nColor\nawby\nReaction\nacid\n1224\n0\nSpecific gravity\nAlbumen\nCasts\nDev\nLeucocytes\nSugar\nNo\nH\n14. Remarks as to fitness of applicant for:\n(a) General hospital service.\n(b) Tropical service\nM.D.\nDate. may 7 1920\nAddress. neutomic Was\nTo be forwarded to the Chairman National Committee on Nursing Service, American Red Cross,\nWashington, D.C.\nREQ. 16-600-JULY-3M"
}