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D M R 29-7019
THE AMERICAN RED CROSS
DEPARTMENT OF NURSING
Physical Examination
1. Name of applicant many m. boodward.
Address 465 38 oinance City Eugress State eregon
2. Age
Height Weight. 125
3. Robust.
General physique
4.
Tendency to disease, inherited or otherwise more
5. Previous history in regard to serious illness or surgical operation norman since
onni gmitts TO gousta abnuag nu 920 g
Childred. and surgical operation
s
6. Has she had rheumatism? no
adgiow
7. Has she at present or has she ever had hernia ? no
8
8.
ground
bezoggo
Condition of teeth
9.
Condition of feet
good ataixo you non 10
e
10.
Abdomen and contained organs
normal
III
+1
11 Chest and contained organs -
3001 101 19q01q no noisiv IsmoA SI
Girth; expiration
30
inches; inspiration 331/2 il
Respiration, rate of
18 Heart, pulse rate so
Right eye (Snellen) 20/10
; corrected to
; lens used
12. Vision:
Left eye (Snellen) 20/20 ;
corrected to
; lens used
13. Hearing: A. D.
20/20-1914 CPNZA S.
20/20 15/15 PAJ.
14. Urine examination:
Color Light Cumber
Reaction
acid
Specific gravity 1020
Albumen
Casts
Leucocytes
Sugar
15. Do you recommend applicant for:
(a) General hospital service you
(b) Tropical service
16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:
Army base hospital
max
Naval base hospital
Emergency detachment
any
Navy detachment
Hospital unit
R.H.Fied
M. D.
Date Sept 12-1921
aas, U.S.H.S.
Address Engine day
All
questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to the local Committee on Red Cross Nursing Service.
23,
3
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"ocrText": "4\nD M R 29-7019\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nPhysical Examination\n1. Name of applicant many m. boodward.\nAddress 465 38 oinance City Eugress State eregon\n2. Age\nHeight Weight. 125\n3. Robust.\nGeneral physique\n4.\nTendency to disease, inherited or otherwise more\n5. Previous history in regard to serious illness or surgical operation norman since\nonni gmitts TO gousta abnuag nu 920 g\nChildred. and surgical operation\ns\n6. Has she had rheumatism? no\nadgiow\n7. Has she at present or has she ever had hernia ? no\n8\n8.\nground\nbezoggo\nCondition of teeth\n9.\nCondition of feet\ngood ataixo you non 10\ne\n10.\nAbdomen and contained organs\nnormal\nIII\n+1\n11 Chest and contained organs -\n3001 101 19q01q no noisiv IsmoA SI\nGirth; expiration\n30\ninches; inspiration 331/2 il\nRespiration, rate of\n18 Heart, pulse rate so\nRight eye (Snellen) 20/10\n; corrected to\n; lens used\n12. Vision:\nLeft eye (Snellen) 20/20 ;\ncorrected to\n; lens used\n13. Hearing: A. D.\n20/20-1914 CPNZA S.\n20/20 15/15 PAJ.\n14. Urine examination:\nColor Light Cumber\nReaction\nacid\nSpecific gravity 1020\nAlbumen\nCasts\nLeucocytes\nSugar\n15. Do you recommend applicant for:\n(a) General hospital service you\n(b) Tropical service\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital\nmax\nNaval base hospital\nEmergency detachment\nany\nNavy detachment\nHospital unit\nR.H.Fied\nM. D.\nDate Sept 12-1921\naas, U.S.H.S.\nAddress Engine day\nAll\nquestions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to the local Committee on Red Cross Nursing Service.\n23,\n3"
}