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D M R 29
B.N.13
THE AMERICAN RED CROSS
NURSING SERVICE
Physical Examination
instan,
I. Name of applicant
alma Ham Scott
Address 1834 W.Janboon City. Chicago
State Ill.
2. Age 33
Height 67 in
Weight 142
4. Tendency to disease, inherited or otherwise none
3. General physique good
5. Previous history in regard to serious illness surgical operation
or
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 normal
IO. contained organs normal
Abdomen and
II. Chest and contained organs normal
Girth; expiration
35
inches; inspiration 38
inches
Respiration, rate of 18
Heart, pulse rate. 74
I2. Vision:
Right eye (Snellen) 20/20 ; corrected to
; lens used
Left eye (Snellen) 20/20 ; corrected
to
; lens used
I3. Hearing: A. D normal
A. S. normal
14. Urine examination:
Color awber
Reaction acid
Specific gravity 1.020
Albumen. 0
Casts 0
Leucocytes.
Sugar
I5. Do you recommend applicant for
(a) General hospital service. you
(b) Tropical service no experience
16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:
Army base hospital
Naval base hospital
DEAM D. Lewis,
Emergency detachment
Director No. 13 Base Hospital
Navy detachment
Hospital unit no 13
M.
D.
Date Jan An questions 26, MUST 1918
Address 1515 W. mousive st
be answered; otherwise certificate will not be accepted at head=
quarters.
for
To be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.
Req. 17-2125B-20M-Nov.
of
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"ocrText": "D M R 29\nB.N.13\nTHE AMERICAN RED CROSS\nNURSING SERVICE\nPhysical Examination\ninstan,\nI. Name of applicant\nalma Ham Scott\nAddress 1834 W.Janboon City. Chicago\nState Ill.\n2. Age 33\nHeight 67 in\nWeight 142\n4. Tendency to disease, inherited or otherwise none\n3. General physique good\n5. Previous history in regard to serious illness surgical operation\nor\n6. Has she had rheumatism? no\n7. Has she at present or has she ever had hernia? no\n8. Condition of teeth good\n9. Condition of feet normal\nIO. contained organs normal\nAbdomen and\nII. Chest and contained organs normal\nGirth; expiration\n35\ninches; inspiration 38\ninches\nRespiration, rate of 18\nHeart, pulse rate. 74\nI2. Vision:\nRight eye (Snellen) 20/20 ; corrected to\n; lens used\nLeft eye (Snellen) 20/20 ; corrected\nto\n; lens used\nI3. Hearing: A. D normal\nA. S. normal\n14. Urine examination:\nColor awber\nReaction acid\nSpecific gravity 1.020\nAlbumen. 0\nCasts 0\nLeucocytes.\nSugar\nI5. Do you recommend applicant for\n(a) General hospital service. you\n(b) Tropical service no experience\n16. Fill in name and number of base hospital, unit or detachment with which applicant is connected:\nArmy base hospital\nNaval base hospital\nDEAM D. Lewis,\nEmergency detachment\nDirector No. 13 Base Hospital\nNavy detachment\nHospital unit no 13\nM.\nD.\nDate Jan An questions 26, MUST 1918\nAddress 1515 W. mousive st\nbe answered; otherwise certificate will not be accepted at head=\nquarters.\nfor\nTo be forwarded to Chief Nurse of Unit or to Committee Organizing Detachment.\nReq. 17-2125B-20M-Nov.\nof"
}