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D M R Form No. 29
fee
F
e
NURSING SERVICE
M.F.S.
+
is
PHYSICAL EXAMINATION
7/11/6
ch
Name of applicant. miss mobel Fletcher not avail. for Service
er
I.
Address 136 Canner st.
City newstain State Come
52
2. Age.
Height 5' 3%2"
Weight 148
M
3. General physique good.
4. Tendency to disease, inherited or otherwise none
abol
5. Pre vious history in regard to serious illness or surgical operation Pneumonia in 1897.
6. Has she had rheumatism? No.
7. Has she at present or has she ever had hernia? no.
8.
Condition of teeth good.
9. Condition of feet good.
IO. Abdomen and contained organs nothing abnormal found.
II. Chest and contained organs
11 , "
a
Expiration 32 %2 / inches.
Inspiration 33
inches.
I2. Vision: o. D. 20/20
Hearing: A. D. match Lo" viin 4011
"
"
" " "
o. S.
320/40 conum 552
A. S.
15
NOTE: In case of refractive error state degree of correction by glasses.
13. Urine examination:
Color
Straw (normal)
acid
Reaction
Specific gravity 1.015
Albumen no.
no.
Casts
Leucocytes Prises. (Probably vagand
Sugar no
14. Do you recommend applicant for:
(a) General hospital service. yes
(b) Tropical service yes
atte
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
Surgical section at
c.7. Bartlett
M. D.
Date may 1.1918
Address 195 Chunch st.
newstann, Com.
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-~20M
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Document data
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"ocrText": "D M R Form No. 29\nfee\nF\ne\nNURSING SERVICE\nM.F.S.\n+\nis\nPHYSICAL EXAMINATION\n7/11/6\nch\nName of applicant. miss mobel Fletcher not avail. for Service\ner\nI.\nAddress 136 Canner st.\nCity newstain State Come\n52\n2. Age.\nHeight 5' 3%2\"\nWeight 148\nM\n3. General physique good.\n4. Tendency to disease, inherited or otherwise none\nabol\n5. Pre vious history in regard to serious illness or surgical operation Pneumonia in 1897.\n6. Has she had rheumatism? No.\n7. Has she at present or has she ever had hernia? no.\n8.\nCondition of teeth good.\n9. Condition of feet good.\nIO. Abdomen and contained organs nothing abnormal found.\nII. Chest and contained organs\n11 , \"\na\nExpiration 32 %2 / inches.\nInspiration 33\ninches.\nI2. Vision: o. D. 20/20\nHearing: A. D. match Lo\" viin 4011\n\"\n\"\n\" \" \"\no. S.\n320/40 conum 552\nA. S.\n15\nNOTE: In case of refractive error state degree of correction by glasses.\n13. Urine examination:\nColor\nStraw (normal)\nacid\nReaction\nSpecific gravity 1.015\nAlbumen no.\nno.\nCasts\nLeucocytes Prises. (Probably vagand\nSugar no\n14. Do you recommend applicant for:\n(a) General hospital service. yes\n(b) Tropical service yes\natte\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\nSurgical section at\nc.7. Bartlett\nM. D.\nDate may 1.1918\nAddress 195 Chunch st.\nnewstann, Com.\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-~20M"
}