Ask the Scholar
Page 35 of 130
I can add historical knowledge about this page.
Page image
OCR
REPORT OF PHYSICAL EXAMINATION
(See AR 40-100 and 40-105)
Instructions - Unless otherwise prescribed. this form will be used for all physical examinations of officers, nurses or warrant officers : applicants for appointment as such in
che Regular Army National Guard. or Officers Reserve Corps and enrollment in the Reserve Officers' Training Corps. Use typewriter if practicable. Attach plain additional
sheets it required.
1.
Fulton
Lavenia
M.
(Last name)
(First name)
(Middle initial)
(Serial number)
2 Civilian applicnt for appointment
Age 31
Years of service
(Grade)
(Organization and arm or service)
(Nearest birthday)
(Whole number only)
3. Nature of examination 1
Appointment
Component of Army
2
Army of U.S.
4. Typhoid vaccination. No. series completed 3
Last series October
19
39
5. Date of last smallpox vaccination
1938 Type of reaction
Vaccinia
6. Other vaccination or immunity tests Typhus March 1912
7. Medical history 3
Usual childhood diseases:
Influenza 1918
No history of Asthma, Hay-fever or Rheumatic-fever.
8. Eyes
Normal
Distant vision Right 20/ 20
correctible to 20/
by 4
(Snellen type) left 20/ 20
correctible to 20/
by 4
Near vision : Right J#
1
correctible to J#
by 4
1
(Jaeger type) Left J#
correctible to J#
by 4
Refraction 5 (under cycloplegic) : Right
Not done
Left Not done
Color perception (red and green) 6
Normal
9. Ears
Normal
Hearing (low conversational voice) : Right 20 /20. Left 20 /20. Audiometer (percent loss): Right- Left
10. Nose and throat
Normal
Tonsils sl. enlarged N.S.
11. Teeth : 7
Right
(Examinee's)
Left
7
6
5
4
3
2
1
1
2
3
4
5
6
Indicate Restorable carious teeth by o : nonrestorable carious
teeth by /: missing natural teeth by X.
16 15
13 12 11 10 9
9 10 11 12 13
Remarks, including other defects
None
Classification IV
Prosthetic dental appliances
None
12. Posture
Good
Figure
Medium
Frame Medium
(Excellent, good. fair, bad)
(Slender, medium, stocky, obese)
(Light, medium, heavy)
13. Temperature 96.4 Height 62 inches. Weight 118 pounds. Chest; Rest 33inches; inspiration 34 inches
expiration 32 inches. Abdomen 28 inches.
14, Cardiovascular system : Heart
Normal
Blood pressure : S. 105 D. 65
Pulse : Rate-Sitting
76
Immediately after exercise 92
Two minutes after exercise 64
Character
Full and Regular
Arteries
Normal
Varicose veins None
15. Respiratory system Normal
16. X-ray of chest 8
Normal
17. Skin and lymphatics
Normal
Endocrine system Normal
18. Bones, joints, and muscles
ormal
Feet
Normal
19. Abdominal viscera
Normal
20. Hernia
None
Hemorrhoids
None
1
Appointment. promotion. retirement. annual active duty, special.
Regular Army National Guard Officer's Reserve Corps: Reserve Officer's Training Corps.
3
If annual physical examination, record only for past year.
4 It annual physical examination. record only distant and near vision, and state whether defect is properly corrected.
5
When indicated.
6
Not required for annual physical examination.
If rejected for appointment in Regular Army because of malocclusion send plaster models to the Surgeon General
Required for candidates for commission.
A.GO FORM
REPRODUCED
HQ. S.O.S. E.T.O.
Page data
- Page
- 35
- Source index
- 0
- Type
- photo
- Media ID
- 693c86c2d82c619b
- Size
- unknown
Document data
- ID
- 2661501
- Core
- doc
- Type
- document
DTO data
{
"id": "2661501",
"sourceUrl": "https://catalog.archives.gov/id/2661501",
"contentType": "document",
"title": "Fulton, Lavinia Martha",
"citationUrl": "https://catalog.archives.gov/id/2661501",
"collections": [
"Records of the American National Red Cross",
"Historical Nurse Files"
],
"iiifBase": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_2421401757_0165/40033_2421401757_0165-00001.tif",
"thumbnailUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_2421401757_0165/40033_2421401757_0165-00001.tif",
"largeImageUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_2421401757_0165/40033_2421401757_0165-00001.tif",
"imageCount": 130,
"hasImages": true,
"source": "import",
"hasTranscription": false
}
Context sent to Scholar
Document identity
{
"localId": "2661501",
"label": "Fulton, Lavinia Martha",
"core": "doc",
"dtoType": "document",
"citationUrl": "https://catalog.archives.gov/id/2661501"
}
Document source metadata
{
"id": "2661501",
"sourceUrl": "https://catalog.archives.gov/id/2661501",
"contentType": "document",
"title": "Fulton, Lavinia Martha",
"citationUrl": "https://catalog.archives.gov/id/2661501",
"collections": [
"Records of the American National Red Cross",
"Historical Nurse Files"
],
"iiifBase": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_2421401757_0165/40033_2421401757_0165-00001.tif",
"thumbnailUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_2421401757_0165/40033_2421401757_0165-00001.tif",
"largeImageUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_2421401757_0165/40033_2421401757_0165-00001.tif",
"imageCount": 130,
"hasImages": true,
"source": "import",
"hasTranscription": false
}
Document source extras
{
"url": "https://catalog.archives.gov/id/2661501",
"naId": 2661501,
"coverageEndDate": {
"day": 31,
"logicalDate": "1942-10-31",
"month": 10,
"year": 1942
},
"coverageStartDate": {
"day": 7,
"logicalDate": "1936-04-07",
"month": 4,
"year": 1936
},
"levelOfDescription": "fileUnit",
"onlineResources": [
{
"description": "Ancestry Collection: 2365",
"note": "This file was scanned as part of a collaboration effort between Ancestry and the National Archives.",
"url": "https://www.ancestryinstitution.com/search/collections/2365/"
}
],
"recordType": "description",
"ocrSource": "nara-archive"
}
Page context
{
"seq": 35,
"pageIndex": 0,
"type": "photo",
"url": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_2421401757_0165/40033_2421401757_0165-00035.tif",
"mediaId": "693c86c2d82c619b",
"ocrText": "REPORT OF PHYSICAL EXAMINATION\n(See AR 40-100 and 40-105)\nInstructions - Unless otherwise prescribed. this form will be used for all physical examinations of officers, nurses or warrant officers : applicants for appointment as such in\nche Regular Army National Guard. or Officers Reserve Corps and enrollment in the Reserve Officers' Training Corps. Use typewriter if practicable. Attach plain additional\nsheets it required.\n1.\nFulton\nLavenia\nM.\n(Last name)\n(First name)\n(Middle initial)\n(Serial number)\n2 Civilian applicnt for appointment\nAge 31\nYears of service\n(Grade)\n(Organization and arm or service)\n(Nearest birthday)\n(Whole number only)\n3. Nature of examination 1\nAppointment\nComponent of Army\n2\nArmy of U.S.\n4. Typhoid vaccination. No. series completed 3\nLast series October\n19\n39\n5. Date of last smallpox vaccination\n1938 Type of reaction\nVaccinia\n6. Other vaccination or immunity tests Typhus March 1912\n7. Medical history 3\nUsual childhood diseases:\nInfluenza 1918\nNo history of Asthma, Hay-fever or Rheumatic-fever.\n8. Eyes\nNormal\nDistant vision Right 20/ 20\ncorrectible to 20/\nby 4\n(Snellen type) left 20/ 20\ncorrectible to 20/\nby 4\nNear vision : Right J#\n1\ncorrectible to J#\nby 4\n1\n(Jaeger type) Left J#\ncorrectible to J#\nby 4\nRefraction 5 (under cycloplegic) : Right\nNot done\nLeft Not done\nColor perception (red and green) 6\nNormal\n9. Ears\nNormal\nHearing (low conversational voice) : Right 20 /20. Left 20 /20. Audiometer (percent loss): Right- Left\n10. Nose and throat\nNormal\nTonsils sl. enlarged N.S.\n11. Teeth : 7\nRight\n(Examinee's)\nLeft\n7\n6\n5\n4\n3\n2\n1\n1\n2\n3\n4\n5\n6\nIndicate Restorable carious teeth by o : nonrestorable carious\nteeth by /: missing natural teeth by X.\n16 15\n13 12 11 10 9\n9 10 11 12 13\nRemarks, including other defects\nNone\nClassification IV\nProsthetic dental appliances\nNone\n12. Posture\nGood\nFigure\nMedium\nFrame Medium\n(Excellent, good. fair, bad)\n(Slender, medium, stocky, obese)\n(Light, medium, heavy)\n13. Temperature 96.4 Height 62 inches. Weight 118 pounds. Chest; Rest 33inches; inspiration 34 inches\nexpiration 32 inches. Abdomen 28 inches.\n14, Cardiovascular system : Heart\nNormal\nBlood pressure : S. 105 D. 65\nPulse : Rate-Sitting\n76\nImmediately after exercise 92\nTwo minutes after exercise 64\nCharacter\nFull and Regular\nArteries\nNormal\nVaricose veins None\n15. Respiratory system Normal\n16. X-ray of chest 8\nNormal\n17. Skin and lymphatics\nNormal\nEndocrine system Normal\n18. Bones, joints, and muscles\normal\nFeet\nNormal\n19. Abdominal viscera\nNormal\n20. Hernia\nNone\nHemorrhoids\nNone\n1\nAppointment. promotion. retirement. annual active duty, special.\nRegular Army National Guard Officer's Reserve Corps: Reserve Officer's Training Corps.\n3\nIf annual physical examination, record only for past year.\n4 It annual physical examination. record only distant and near vision, and state whether defect is properly corrected.\n5\nWhen indicated.\n6\nNot required for annual physical examination.\nIf rejected for appointment in Regular Army because of malocclusion send plaster models to the Surgeon General\nRequired for candidates for commission.\nA.GO FORM\nREPRODUCED\nHQ. S.O.S. E.T.O."
}