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Pres. Homp, #2
AMERICAN RED CROSS NURSING SERVICE
PHYSICAL EXAMINATION
1. Name of Applicant
Orelin Young
2. Age 88
Height
5'6" Weight 130.
3. General appearance
Healthy
4. Are your parents living ?
5. If not, at what age and of what disease did each die?
6. Tendency inherited otherwise Tryative
to disease, or ?
7. Previous history in regard to serious illness or surgical operation Vegalu
8. Have you had rheumatism ? neyative
9. Have you present have you had hernia ? legative
at or ever
10. Condition of teeth
11. Condition of feet } Food
negative
12. Abdomen and contained organs Vegative
13. Chest and contained organs
negative
Expiration
inches.
Inspiration
inches.
14.
Vision : O.S. O.D. 5 negative
Hearing : A.D. 3 negative
A. S.
15. Urine Examination :
Color
Reaction and
Specific Gravity
Albumen
Casts I
Leucocytes of
Sugar
0
16. Remarks as to fitness of applicant for :
(a) General hospital service
applicant fit physically for any
General Haskilat Service
(b) Tropical service Yes
Nines
M.D.
Date July 15/16.
Address Pres by terian Hospital.
u.y.C.
To be forwarded by the nurse, with duplicate Certificate of Immunity, to Chairman National Committee on
Nursing Service, American Red Cross, Washington, DC.
Discular
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- Type
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Document data
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- Type
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"ocrText": "Pres. Homp, #2\nAMERICAN RED CROSS NURSING SERVICE\nPHYSICAL EXAMINATION\n1. Name of Applicant\nOrelin Young\n2. Age 88\nHeight\n5'6\" Weight 130.\n3. General appearance\nHealthy\n4. Are your parents living ?\n5. If not, at what age and of what disease did each die?\n6. Tendency inherited otherwise Tryative\nto disease, or ?\n7. Previous history in regard to serious illness or surgical operation Vegalu\n8. Have you had rheumatism ? neyative\n9. Have you present have you had hernia ? legative\nat or ever\n10. Condition of teeth\n11. Condition of feet } Food\nnegative\n12. Abdomen and contained organs Vegative\n13. Chest and contained organs\nnegative\nExpiration\ninches.\nInspiration\ninches.\n14.\nVision : O.S. O.D. 5 negative\nHearing : A.D. 3 negative\nA. S.\n15. Urine Examination :\nColor\nReaction and\nSpecific Gravity\nAlbumen\nCasts I\nLeucocytes of\nSugar\n0\n16. Remarks as to fitness of applicant for :\n(a) General hospital service\napplicant fit physically for any\nGeneral Haskilat Service\n(b) Tropical service Yes\nNines\nM.D.\nDate July 15/16.\nAddress Pres by terian Hospital.\nu.y.C.\nTo be forwarded by the nurse, with duplicate Certificate of Immunity, to Chairman National Committee on\nNursing Service, American Red Cross, Washington, DC.\nDiscular"
}