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II Howei lint REV. FORM JULY 1193 1941 AMERICAN RED CROSS NURSING SERVICE PHYSICAL EXAMINATION (All questions must be answered by definite statements) 1. Name of applicant Elinabeth Wright Address 3177- Magnolia City Corpay christ State Texas 2. Age 40 Height 5'4" Weight 192 3. Family history Denier history (feet inches) (pounds) and 4. Past history General 1924 - health, operation, Adhesion injury, any illnesses exploratory (Indicate dates) leparatory Appendectomy 1931 1923, 5. General physique standy overweight RR. eye 20/22 JRt.20/ 6. Distant Vision: Without glasses } Rt. norm Lt. eye 20/20 With glasses Lt. 20 Evidence of disease Lt. norn Note: Actual vision should be determined on proper letters for 20 foot distant, as 20-20, 20-30, 20-100, etc. Rt. ear 70/20 ft. } (Rt. none 7. Hearing: (Whispered voice) Lt. ear 20/20 ft. Evidence of disease Lt. none 8. Teeth and gums: (Note abnormalities) none Directions: Indicate as follows- Right Applicant's Left X Missing tooth U8 654321 Teeth: 1234548 8 Bridgework L8 654321 1234567 8 Crown 9. Nose and DriOK Throat mayo "Plate"-write out word to indicate plate. 10. Neck: (Thyroid Thyroid not palpable gland and other abnormalities) no pulpable ademopathy normal 11. Skeletal: (Bones joints, muscles, and feet) frac ares or deformation No) missing et tremite 12. Thorax: Expiration 39 inches Inspiration 42 inches Respiration 18 minute Lungs to percussion and auscultation. per Reynant and clear Cardio-vascular system no abnormalities Heart: Size normal Murmurs none Pulse 80 Blood pressure: Syst. 118 Dias. 80 (OVER)

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    "ocrText": "II\nHowei lint REV. FORM JULY 1193 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nPHYSICAL EXAMINATION\n(All questions must be answered by definite statements)\n1. Name of applicant Elinabeth Wright\nAddress 3177- Magnolia City Corpay christ State Texas\n2. Age\n40\nHeight\n5'4\"\nWeight 192\n3. Family history Denier history (feet inches) (pounds)\nand\n4. Past history General 1924 - health, operation, Adhesion injury, any illnesses exploratory (Indicate dates) leparatory Appendectomy 1931 1923,\n5. General\nphysique standy overweight\nRR. eye 20/22\nJRt.20/\n6. Distant Vision: Without glasses\n}\nRt. norm\nLt. eye 20/20 With glasses Lt. 20\nEvidence of disease\nLt. norn\nNote: Actual vision should be determined on proper letters for 20 foot distant, as 20-20, 20-30, 20-100, etc.\nRt. ear 70/20 ft.\n}\n(Rt. none\n7. Hearing: (Whispered voice) Lt. ear 20/20 ft.\nEvidence of disease\nLt. none\n8. Teeth and gums: (Note abnormalities)\nnone\nDirections: Indicate as follows-\nRight\nApplicant's\nLeft\nX\nMissing tooth\nU8 654321\nTeeth:\n1234548 8\nBridgework\nL8 654321\n1234567\n8\nCrown\n9. Nose and\nDriOK Throat mayo\n\"Plate\"-write out word to indicate plate.\n10. Neck: (Thyroid\nThyroid not palpable\ngland and other abnormalities) no pulpable ademopathy\nnormal\n11. Skeletal: (Bones joints, muscles, and feet)\nfrac ares or deformation\nNo) missing et tremite\n12. Thorax: Expiration\n39\ninches\nInspiration 42\ninches\nRespiration 18 minute\nLungs to percussion and auscultation. per\nReynant and clear\nCardio-vascular system\nno abnormalities\nHeart: Size normal\nMurmurs none\nPulse 80\nBlood pressure: Syst. 118 Dias. 80\n(OVER)"
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