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D MR Form No. 29
TH EL IMMERICANREDIA COOSE
NURSING SERVICE
ASHINGTON
HUMANITY
DON
c
PHYSICAL EXAMINATION
13711
put
I. Name of applicant
Catherine Stuart Jover
Address
161 w61st St
City n.y
State n.y
2. Age
32 yrs.
Height 5ft.4under Weight 118
3. General physique
good
4. Tendency to disease, inherited or otherwise nine
5. Previous history in regard to serious illness or surgical operation - new
6.
Has she had rheumatism? - acute articular in 1913- lasted
7. Has she at present or has she ever had hernia?
no
8. Condition of teeth all decayed teut filled otherwise soon
9. Condition
of feet 9 and / Callous
IO. Abdomen and contained organs normal
11. Chest and contained organs
annual
Expiration
30
inches.
33
Inspiration
inches.
12. Vision: O.D. 20/20
Hearing: A. D. got
O. S. 2/20
A. S. gas
NOTE: In case of refractive error state degree of correction by glasses.
13. Urine examination:
Color
Shaw
Reaction
Wildown
Specific gravity
1.630
Albumen
worr
Casts
nine
Leucocytes
few.
Sugar
nme
14. Do you recommend applicant for:
(a) General hospital service you
(b) Tropical service
15. Fill in location of base hospital, unit or detachment with which service is desired:
Army base hospital at
Naval base hospital at
Emergency detachment at
Navy detachment at
Hospital unit at Children's Hospital (2) PediaTric Unit
Surgical section at
g7 fammis
M. D.
Date sept 141 197
Address
272 wgost n.y-
All questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
Req. 17-833-May-2cm
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"ocrText": "D MR Form No. 29\nTH EL IMMERICANREDIA COOSE\nNURSING SERVICE\nASHINGTON\nHUMANITY\nDON\nc\nPHYSICAL EXAMINATION\n13711\nput\nI. Name of applicant\nCatherine Stuart Jover\nAddress\n161 w61st St\nCity n.y\nState n.y\n2. Age\n32 yrs.\nHeight 5ft.4under Weight 118\n3. General physique\ngood\n4. Tendency to disease, inherited or otherwise nine\n5. Previous history in regard to serious illness or surgical operation - new\n6.\nHas she had rheumatism? - acute articular in 1913- lasted\n7. Has she at present or has she ever had hernia?\nno\n8. Condition of teeth all decayed teut filled otherwise soon\n9. Condition\nof feet 9 and / Callous\nIO. Abdomen and contained organs normal\n11. Chest and contained organs\nannual\nExpiration\n30\ninches.\n33\nInspiration\ninches.\n12. Vision: O.D. 20/20\nHearing: A. D. got\nO. S. 2/20\nA. S. gas\nNOTE: In case of refractive error state degree of correction by glasses.\n13. Urine examination:\nColor\nShaw\nReaction\nWildown\nSpecific gravity\n1.630\nAlbumen\nworr\nCasts\nnine\nLeucocytes\nfew.\nSugar\nnme\n14. Do you recommend applicant for:\n(a) General hospital service you\n(b) Tropical service\n15. Fill in location of base hospital, unit or detachment with which service is desired:\nArmy base hospital at\nNaval base hospital at\nEmergency detachment at\nNavy detachment at\nHospital unit at Children's Hospital (2) PediaTric Unit\nSurgical section at\ng7 fammis\nM. D.\nDate sept 141 197\nAddress\n272 wgost n.y-\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-833-May-2cm"
}