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DMR 29
THE AMERICAN RED CROSS
DEPARTMENT OF NURSING
Physical Examination
1. Name of applicant Juliet Snyder
Address 417 Prestm It City Multidelphine State, Pa. -
2. Age 43 yrs.
Robnit
Height 5 ft 4 1/8 inclus Weight 1271bo
3. General physique
4. Tendency to disease, inherited or otherwise Annanc (more)
5.
Previous history in regard to serious illness or surgical operation operation 13900
Exception Has she had children rheumatism ? disease Mr Pneuminin1202 1290
6.
7. Has she at present or has she ever had hernia?
Mr.
8. Condition of teeth
good -
9.
Condition of feet 2ird 1
10. Abdomen and contained organs apparently Manal
11.
Chest and contained organs normal
33/m
Girth; expiration
inches; inspiration 37 in
inches
Respiration, rate of 20
Heart, rate 80
pulse
Right eye (Snellen) 20
;
corrected 200 to + 2.25+ 37-4fros35 Jonic
; lens used
12. Vision
Left eye (Snellen) 240
;
corrected 20/ to +2.50
; lens used
13. Hearing: A. 20 #
A. S 20/X
match
3pt
match
3pt.
14. Urine examination
Color amber
and
Reaction
Specific gravity 1016
Albumen negative
Casts nme
Leucocytes negative
Sugar nme
15. Do you recommend applicant for:
(a) General hospital service.
France
(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
2/Hurst maie
M. D.
Date fine 27-1918.
Address 2035 Meetnut Lt.
All questions MUST be answered; otherwise certificate will not be accepted at headquarters.
To be forwarded to Chief Nurse of Unit or to Local Committee on Red Cross Nursing Service.
Req. 17-14224-1M-Mar.
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"ocrText": "DMR 29\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nPhysical Examination\n1. Name of applicant Juliet Snyder\nAddress 417 Prestm It City Multidelphine State, Pa. -\n2. Age 43 yrs.\nRobnit\nHeight 5 ft 4 1/8 inclus Weight 1271bo\n3. General physique\n4. Tendency to disease, inherited or otherwise Annanc (more)\n5.\nPrevious history in regard to serious illness or surgical operation operation 13900\nException Has she had children rheumatism ? disease Mr Pneuminin1202 1290\n6.\n7. Has she at present or has she ever had hernia?\nMr.\n8. Condition of teeth\ngood -\n9.\nCondition of feet 2ird 1\n10. Abdomen and contained organs apparently Manal\n11.\nChest and contained organs normal\n33/m\nGirth; expiration\ninches; inspiration 37 in\ninches\nRespiration, rate of 20\nHeart, rate 80\npulse\nRight eye (Snellen) 20\n;\ncorrected 200 to + 2.25+ 37-4fros35 Jonic\n; lens used\n12. Vision\nLeft eye (Snellen) 240\n;\ncorrected 20/ to +2.50\n; lens used\n13. Hearing: A. 20 #\nA. S 20/X\nmatch\n3pt\nmatch\n3pt.\n14. Urine examination\nColor amber\nand\nReaction\nSpecific gravity 1016\nAlbumen negative\nCasts nme\nLeucocytes negative\nSugar nme\n15. Do you recommend applicant for:\n(a) General hospital service.\nFrance\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\n2/Hurst maie\nM. D.\nDate fine 27-1918.\nAddress 2035 Meetnut Lt.\nAll questions MUST be answered; otherwise certificate will not be accepted at headquarters.\nTo be forwarded to Chief Nurse of Unit or to Local Committee on Red Cross Nursing Service.\nReq. 17-14224-1M-Mar."
}