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DMR29-N.E.D. THE AMERICAN RED CROSS DEPARTMENT OF NURSING Physical Examination 1. Name of applicant Address 238 Webster Street City East Boston State mease Stella Goostray 2. Age 33 Height Weight 122 (indoor clothes 3. General physique ford. 4. Tendency to disease, inherited or otherwise none. 5. Previous history in regard to serious illness or surgical operation Typloid Fever 1916. Complicated with persumonia. 6. Has she had rheumatism ? Following typleod no offand on for 6mos. 1916 7. Has she at present or has she ever had hernia? 8. Condition of teeth good Crounds - ( (nular - I licenseal 9. Condition of feet Rt. foot arch flattered no meonvenence 10. Abdomen and contained organs negative 11. Chest and contained organs negative Girth; expiration 29 inches; inspiration 36% inches Respiration, rate of 16 Heart, pulse rate 78 Right eye (Snellen) 20/15 ; corrected to 20/15 ; lens used spher 12. Vision:< Left eye (Snellen) 20/20 ; corrected to 70/20 ; lens used 25-==75gl.90 13. A. D. 15/15 Hearing: A. S. 15/15 14. Urine examination: Color amber Reaction albaline Specific gravity 1.030 Albumen absent Casts none Leucocytes negative Sugar absent 15. Do you recommend applicant for: (a) General hospital service you (b) Tropical service 16. Fill in name and number of base hospital, unit or detachment with which applicant is connected: Army base hospital Naval base hospital Emergency detachment Navy detachment Hospital unit Me. A. M. D. Date Ceptrial 26- 1920. Address Teacher College All questions MUST be answered; otherwise certificate will not be accepted at headquarters. To be forwarded to Chief Nurse of Unit or to the Local Committee Organizing Detachment on Red Cross Nursing Service. (SEE OTHER SIDE)

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0
Type
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Media ID
973a73c56fc65cb8
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2661546
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Document identity
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Document source extras
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    "naId": 2661546,
    "coverageEndDate": {
        "day": 13,
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Page context
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    "ocrText": "DMR29-N.E.D.\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nPhysical Examination\n1. Name of applicant\nAddress 238 Webster Street City East Boston State mease\nStella Goostray\n2. Age 33\nHeight Weight 122 (indoor clothes\n3. General physique ford.\n4. Tendency to disease, inherited or otherwise none.\n5. Previous history in regard to serious illness or surgical operation Typloid Fever 1916.\nComplicated with persumonia.\n6. Has she had rheumatism ? Following typleod no offand on for 6mos. 1916\n7. Has she at present or has she ever had hernia?\n8. Condition of teeth good Crounds - ( (nular - I licenseal\n9.\nCondition of feet Rt. foot arch flattered no meonvenence\n10. Abdomen and contained organs negative\n11. Chest and contained organs negative\nGirth; expiration\n29\ninches; inspiration 36% inches\nRespiration, rate of\n16\nHeart,\npulse rate 78\nRight eye (Snellen) 20/15 ; corrected to 20/15 ; lens used spher\n12. Vision:<\nLeft eye (Snellen) 20/20\n;\ncorrected to 70/20\n; lens used 25-==75gl.90\n13. A. D. 15/15\nHearing:\nA. S.\n15/15\n14. Urine examination:\nColor amber\nReaction albaline\nSpecific gravity 1.030\nAlbumen absent\nCasts\nnone\nLeucocytes negative\nSugar absent\n15. Do you recommend applicant for:\n(a) General hospital service you\n(b) Tropical service\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital\nNaval base hospital\nEmergency detachment\nNavy detachment\nHospital unit\nMe. A.\nM. D.\nDate Ceptrial 26- 1920.\nAddress Teacher College\nAll questions MUST be answered; otherwise certificate will not be accepted at\nheadquarters.\nTo be forwarded to Chief Nurse of Unit or to the Local Committee Organizing\nDetachment on Red Cross Nursing Service.\n(SEE OTHER SIDE)"
}