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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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"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"
}