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Miss Vera Eldridge,
RS
I. OCCUPATION
Forewoman
On this sheet are recorded the physical
findings without comment or explanation.
It is meant to serve as a record for your
future use and as a statement of our find-
2. FAMILY HISTORY
ings in case it is necessary for you to con-
sult a doctor.
Heart trouble
All items of importance to you are dis-
cussed and explained in the attached letter
signed by the Medical Director.
If there are conditions requiring treat-
3. PERSONAL HISTORY
ment, submit this report to your physician.
LOSS of wei ght
Frequent sore throat
4.
PHYSIQUE
Height (in shoes)
5
Ft.3 In.
Chest at rest
301
In. Abdomen 30
In.
Net
5
Ft.] In.
Present weight (coat, vest or waist off)
115
Lbs.
Ideal weight
116
Lbs.
''
Net
112
Lbs.
For height (allowance made for frame if
reported light or heavy)
Posture Fair
Skeleton and Extremities aulty shoes worn
Musculature
Fa
5. CIRCULATION
Hemoglobin
75
%
Pulse 120 per min. Character regular
2 min. after exercise
94
Blood Pressure:
Systolic
150
Diastolic 92
Body Temperature
98.2
''
"
144
" 84
2 min. after exercise
Radials (at wrist)
Normal (healthy)
Average Systolic Pressure
Blood Vessels
Brachials (at elbow)
Millimeters
Ages 15 to 20
120
Retinals (internal eye)
21 to 25
123
"
Temporals
26 to 30
124
..
31 to 35
124
Other
"
36 to 40
127
"
41 to 45
129
Heart
"
46 to 50
131
"
51 to 55
132
"
56 to 60
135
In health the blood pressure may vary
temporary 15 mm. above or below the
average. Wide variations sometimes occur
from slight nervous troubles.
Normal (healthy)
Pressures persistently above or below
the average should, however, be carefully
studied and followed up.
Normal pulse pressure, the difference
between systolic and diastolic, ranges
from 30 to 55 mm.
Blood pressure of women averages
about 10 mm. less than that of men.
6. LUNGS
Normal (healthy)
7. ABDOMINAL ORGANS
Drooping of abdominal organs.
Right kidney prolapsed.
Statement of moderate constipation.
History of round worm.
8. GENITO URINARY
Pelvic examination per rectum-normal.
Urine normal.
Form 503
203
9. BRAIN AND NERVOUS SYSTEM
Slight fine tremors.
10. SKIN, LYMPHATICS, AND VEINS
Extremities bluish.
II. ENDOCRINE GLANDS
Possibility of oversecretion of endocrine organs.
12. NOSE AND THROAT
Septum slightly deviated.
Turbinates slightly enlarged.
Tonsils slightly enlarged, buried and cryptic.
13. MOUTH, TEETH AND GUMS See x-ray report.
MFMFF
P
FFF
87654321 : 12345678 Upper
M 7 5 4 321 : 12345678 Lower
Key to above
Gums
D-Decay
M-Missing
Anemic
F-Filled
O-Cavities
Bleeding
C-Caps
P-Pyorrhea
Infection
Cr-Crown
X-Recession
Markings
S-Pivot
T-Tartar
Discharging sinus
R-Roots
L-Loose
Odor
B-Bridge
I-Infected
J-Malocclusion (Irregular)
H-Pulpless
Tongue
14. EARS
Right
10/10
Left 10/10
Canal and Drum
normal
15. EYES
Right 20/15
Left 20/15
Corrected to
-
Eye Grounds
-
Astigmatism No
Color Vision -
-
Disease of eyes or eyelids
16. URINARY REPORT
PHYSICAL CHARACTERISTICS
MICROSCOPIC EXAMINATION
Centrifugalized Specimen
Specific Gravity 1.020
Casts
Transparency clear
Hyaline
Granular
Color
pale amber
Epithelial
none
Cylindroids
Odor
few
Reaction
acid
Epithelial Cells
few
Leucocytes (white blood cells)
Sediment
none
CHEMICAL REACTION
Pus
none
Albumin none
Indican
none
Erythrocytes
none
Crystals
none
Sugar
Bile none
few threads
Mucus
Acetone
Diacetic Acid
few urates
Amorphous
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"ocrText": "Miss Vera Eldridge,\nRS\nI. OCCUPATION\nForewoman\nOn this sheet are recorded the physical\nfindings without comment or explanation.\nIt is meant to serve as a record for your\nfuture use and as a statement of our find-\n2. FAMILY HISTORY\nings in case it is necessary for you to con-\nsult a doctor.\nHeart trouble\nAll items of importance to you are dis-\ncussed and explained in the attached letter\nsigned by the Medical Director.\nIf there are conditions requiring treat-\n3. PERSONAL HISTORY\nment, submit this report to your physician.\nLOSS of wei ght\nFrequent sore throat\n4.\nPHYSIQUE\nHeight (in shoes)\n5\nFt.3 In.\nChest at rest\n301\nIn. Abdomen 30\nIn.\nNet\n5\nFt.] In.\nPresent weight (coat, vest or waist off)\n115\nLbs.\nIdeal weight\n116\nLbs.\n''\nNet\n112\nLbs.\nFor height (allowance made for frame if\nreported light or heavy)\nPosture Fair\nSkeleton and Extremities aulty shoes worn\nMusculature\nFa\n5. CIRCULATION\nHemoglobin\n75\n%\nPulse 120 per min. Character regular\n2 min. after exercise\n94\nBlood Pressure:\nSystolic\n150\nDiastolic 92\nBody Temperature\n98.2\n''\n\"\n144\n\" 84\n2 min. after exercise\nRadials (at wrist)\nNormal (healthy)\nAverage Systolic Pressure\nBlood Vessels\nBrachials (at elbow)\nMillimeters\nAges 15 to 20\n120\nRetinals (internal eye)\n21 to 25\n123\n\"\nTemporals\n26 to 30\n124\n..\n31 to 35\n124\nOther\n\"\n36 to 40\n127\n\"\n41 to 45\n129\nHeart\n\"\n46 to 50\n131\n\"\n51 to 55\n132\n\"\n56 to 60\n135\nIn health the blood pressure may vary\ntemporary 15 mm. above or below the\naverage. Wide variations sometimes occur\nfrom slight nervous troubles.\nNormal (healthy)\nPressures persistently above or below\nthe average should, however, be carefully\nstudied and followed up.\nNormal pulse pressure, the difference\nbetween systolic and diastolic, ranges\nfrom 30 to 55 mm.\nBlood pressure of women averages\nabout 10 mm. less than that of men.\n6. LUNGS\nNormal (healthy)\n7. ABDOMINAL ORGANS\nDrooping of abdominal organs.\nRight kidney prolapsed.\nStatement of moderate constipation.\nHistory of round worm.\n8. GENITO URINARY\nPelvic examination per rectum-normal.\nUrine normal.\nForm 503\n203\n9. BRAIN AND NERVOUS SYSTEM\nSlight fine tremors.\n10. SKIN, LYMPHATICS, AND VEINS\nExtremities bluish.\nII. ENDOCRINE GLANDS\nPossibility of oversecretion of endocrine organs.\n12. NOSE AND THROAT\nSeptum slightly deviated.\nTurbinates slightly enlarged.\nTonsils slightly enlarged, buried and cryptic.\n13. MOUTH, TEETH AND GUMS See x-ray report.\nMFMFF\nP\nFFF\n87654321 : 12345678 Upper\nM 7 5 4 321 : 12345678 Lower\nKey to above\nGums\nD-Decay\nM-Missing\nAnemic\nF-Filled\nO-Cavities\nBleeding\nC-Caps\nP-Pyorrhea\nInfection\nCr-Crown\nX-Recession\nMarkings\nS-Pivot\nT-Tartar\nDischarging sinus\nR-Roots\nL-Loose\nOdor\nB-Bridge\nI-Infected\nJ-Malocclusion (Irregular)\nH-Pulpless\nTongue\n14. EARS\nRight\n10/10\nLeft 10/10\nCanal and Drum\nnormal\n15. EYES\nRight 20/15\nLeft 20/15\nCorrected to\n-\nEye Grounds\n-\nAstigmatism No\nColor Vision -\n-\nDisease of eyes or eyelids\n16. URINARY REPORT\nPHYSICAL CHARACTERISTICS\nMICROSCOPIC EXAMINATION\nCentrifugalized Specimen\nSpecific Gravity 1.020\nCasts\nTransparency clear\nHyaline\nGranular\nColor\npale amber\nEpithelial\nnone\nCylindroids\nOdor\nfew\nReaction\nacid\nEpithelial Cells\nfew\nLeucocytes (white blood cells)\nSediment\nnone\nCHEMICAL REACTION\nPus\nnone\nAlbumin none\nIndican\nnone\nErythrocytes\nnone\nCrystals\nnone\nSugar\nBile none\nfew threads\nMucus\nAcetone\nDiacetic Acid\nfew urates\nAmorphous"
}