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REMARKS This is a true copy of orrignal in my possesion. STATION OR COMMAND INSTRUCTIONS 1. A record will be kept on cards of this form, except as otherwise specially authorized, of all vaccinations against typhoid fever, paratyphoid fever, and smallpox given under the direction of medical officers to officers, enlisted men, and civilian employees of the Army, and to other civilians accom- panying or resident with military commands. 2. The card will be begun in each case immediately upon giving either vaccination, making proper entry thereof, which will be authenticated by the initials of the responsible medi- cal officer. The other blank spaces on the card will be filled out as soon as practicable. 3. In the case of a civilian employee, the character of his employment (clerk, teamster, etc.) and the staff corps or department in which he is employed will be noted in the spaces rank, company, and regiment. A brief notation of the status of other civilians will be made in the same spaces. 4. The result of the vaccination against smallpox will be recorded as successful or unsuccessful. The term protected will not be used. 5. The cards will be filed by classes (officers, enlisted men, civilian employees, and other civilians separately), each class by names in dictionary order. The cards of enlisted men, civilian employees, and civilians may be destroyed after 5 years from the date of the last vaccination recorded thereon. 6. Supplemental or continuation cards will be prepared and attached to the original cards as necessary. 7. Should the soldier leave the command en route to an- other command before the result of the vaccination against smallpox is ascertained or before the third dose of typhoid or paratyphoid vaccine is given, a duplicate of the incomplete vaccination card should be sent by the surgeon direct to the surgeon of the new command for the latter's guidance in com- pleting the procedure. Form 81 MEDICAL DEPARTMENT, U. S. A. (Revised March 20, 1917.) Ed. Mar. 21-17-1,000,000. 3-3460 VACCINATION REGISTER Truman Harry S. SURNAME CHRISTIAN NAME 1st Lieut F 129th. F.A. RANK COMPANY REGIMENT OR STAFF CORPS Enlisted , 19 At Date of birth , 19 Triple TYPHOID VACCINATION AGAINST DOSE TEMPERATURE DATE INITIALS First $00. 1 Sept. 17/17 asw Second loc XXXXXXX Sept. Sept.22/17 lew Third 1cc XXXXXXX Oct.5/17 Oct. 5/17 C/EW LAST PREVIOUS VACCINATION AGAINST DATE PLACE NO. OF DOSES HISTORY OF TYPHOID FEVER, IF ANY YEAR PLACE PARATYPHOID VACCINATION AGAINST DOSE TEMPERATURE DATE INITIALS First Second XXXXXXX Third XXXXXXX LAST PREVIOUS VACCINATION AGAINST DATE PLACE NO. OF DOSES HISTORY OF PARATYPHOID FEVER, IF ANY YEAR PLACE SMALLPOX VACCINATION AGAINST DATE RESULT Successful CEW INITIALS Sept.17/17 LAST PREVIOUS SUCCESSFUL VACCINATION AGAINST DATE PLACE HISTORY OF SMALLPOX, IF ANY YEAR PLACE 3-3460

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Page context
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    "ocrText": "REMARKS\nThis is a true copy of orrignal\nin my possesion.\nSTATION OR COMMAND\nINSTRUCTIONS\n1. A record will be kept on cards of this form, except as\notherwise specially authorized, of all vaccinations against\ntyphoid fever, paratyphoid fever, and smallpox given under\nthe direction of medical officers to officers, enlisted men, and\ncivilian employees of the Army, and to other civilians accom-\npanying or resident with military commands.\n2. The card will be begun in each case immediately upon\ngiving either vaccination, making proper entry thereof, which\nwill be authenticated by the initials of the responsible medi-\ncal officer. The other blank spaces on the card will be filled\nout as soon as practicable.\n3. In the case of a civilian employee, the character of his\nemployment (clerk, teamster, etc.) and the staff corps or\ndepartment in which he is employed will be noted in the\nspaces rank, company, and regiment. A brief notation of the\nstatus of other civilians will be made in the same spaces.\n4. The result of the vaccination against smallpox will be\nrecorded as successful or unsuccessful. The term protected will\nnot be used.\n5. The cards will be filed by classes (officers, enlisted men,\ncivilian employees, and other civilians separately), each class\nby names in dictionary order. The cards of enlisted men,\ncivilian employees, and civilians may be destroyed after 5\nyears from the date of the last vaccination recorded thereon.\n6. Supplemental or continuation cards will be prepared\nand attached to the original cards as necessary.\n7. Should the soldier leave the command en route to an-\nother command before the result of the vaccination against\nsmallpox is ascertained or before the third dose of typhoid or\nparatyphoid vaccine is given, a duplicate of the incomplete\nvaccination card should be sent by the surgeon direct to the\nsurgeon of the new command for the latter's guidance in com-\npleting the procedure.\nForm 81\nMEDICAL DEPARTMENT, U. S. A.\n(Revised March 20, 1917.)\nEd. Mar. 21-17-1,000,000.\n3-3460\nVACCINATION REGISTER\nTruman\nHarry S.\nSURNAME\nCHRISTIAN NAME\n1st Lieut F\n129th. F.A.\nRANK\nCOMPANY\nREGIMENT OR STAFF CORPS\nEnlisted\n, 19\nAt\nDate of birth\n, 19\nTriple\nTYPHOID\nVACCINATION AGAINST\nDOSE\nTEMPERATURE\nDATE\nINITIALS\nFirst $00. 1\nSept. 17/17\nasw\nSecond loc\nXXXXXXX\nSept. Sept.22/17\nlew\nThird 1cc\nXXXXXXX\nOct.5/17 Oct. 5/17\nC/EW\nLAST PREVIOUS VACCINATION AGAINST\nDATE\nPLACE\nNO. OF DOSES\nHISTORY OF TYPHOID FEVER, IF ANY\nYEAR\nPLACE\nPARATYPHOID\nVACCINATION AGAINST\nDOSE\nTEMPERATURE\nDATE\nINITIALS\nFirst\nSecond\nXXXXXXX\nThird\nXXXXXXX\nLAST PREVIOUS VACCINATION AGAINST\nDATE\nPLACE\nNO. OF DOSES\nHISTORY OF PARATYPHOID FEVER, IF ANY\nYEAR\nPLACE\nSMALLPOX\nVACCINATION AGAINST\nDATE\nRESULT\nSuccessful\nCEW\nINITIALS\nSept.17/17\nLAST PREVIOUS SUCCESSFUL VACCINATION AGAINST\nDATE\nPLACE\nHISTORY OF SMALLPOX, IF ANY\nYEAR\nPLACE\n3-3460"
}