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MADIRIMA
13. Abdomen: (condition of wall, scars, herniae, and abnormality of viscera)
well beeled afbendation New
Circumference of abdomen at umbilicus 24 IN,
14. Nervous system: (note organic or functional disorders)
None
15. Urinalysis: Sp. Gr. 1020 Albumin 0 Sugar 0 Microscopical
16. Date of immunization against, Smallpox
1919
Typhoid 1934
17. Remarks on abnormalities not otherwise noted or sufficiently described on this blank:
None
bean ane,
Is
the applicant fit to perform active duty (Military, Disaster, etc.?)
year
i
If not, state type of duty she is physically fitted to perform
3
wow 910
Date 10/19/40
Chan/ abilities?
Examiner
suon) :emug bris diseT
8
Anold to shis no
10
"
12
13
14
IS
se
y
v
17
R
blony(T)
n
A
17
18 19 20 21 22 23 24 25 26 27 28 29 30 31
02
(deal
bria
.I.
Indicate missing teeth by "X", bridge work by C crowns by
,
plates by word
"plate".
serfont
All questions MUST be answered; otherwise certificate will not be accepted at Head-
quarters. To be forwarded to the Local Committee on Red Cross Nursing Service.
1.
Be sure that all items are filled in before forwarding. Make definite statements in all instances.
2. Give age in years, height in inches, weight in pounds.
12. Chest measurements should be in total inches.
a
a
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"ocrText": "MADIRIMA\n13. Abdomen: (condition of wall, scars, herniae, and abnormality of viscera)\nwell beeled afbendation New\nCircumference of abdomen at umbilicus 24 IN,\n14. Nervous system: (note organic or functional disorders)\nNone\n15. Urinalysis: Sp. Gr. 1020 Albumin 0 Sugar 0 Microscopical\n16. Date of immunization against, Smallpox\n1919\nTyphoid 1934\n17. Remarks on abnormalities not otherwise noted or sufficiently described on this blank:\nNone\nbean ane,\nIs\nthe applicant fit to perform active duty (Military, Disaster, etc.?)\nyear\ni\nIf not, state type of duty she is physically fitted to perform\n3\nwow 910\nDate 10/19/40\nChan/ abilities?\nExaminer\nsuon) :emug bris diseT\n8\nAnold to shis no\n10\n\"\n12\n13\n14\nIS\nse\ny\nv\n17\nR\nblony(T)\nn\nA\n17\n18 19 20 21 22 23 24 25 26 27 28 29 30 31\n02\n(deal\nbria\n.I.\nIndicate missing teeth by \"X\", bridge work by C crowns by\n,\nplates by word\n\"plate\".\nserfont\nAll questions MUST be answered; otherwise certificate will not be accepted at Head-\nquarters. To be forwarded to the Local Committee on Red Cross Nursing Service.\n1.\nBe sure that all items are filled in before forwarding. Make definite statements in all instances.\n2. Give age in years, height in inches, weight in pounds.\n12. Chest measurements should be in total inches.\na\na"
}