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BEORO 038 MADIR3MA D. Has the applicant ever suffered from any disease D no or functional derangement of the respiratory system ? If yes, state particulars. menimex3 to 35 inche E. What is the chest circumferecnce? E Upon full inspiration ? 3> niches 33 wich Upon full expiration? III. The Circulatory System. A. What is the temperature of the body? (If III. A 98.6 over 99° in the mouth, try another day.) B. Give the rate and other qualities of the pulse. B Record blood-pressure. 72 120 pull refregeles W. C. Does it intermit, or become irregular or un- C no equal? to D. Does physical examination reveal anything D no whatever abnormal in the conditions of the heart or blood vessels? a E. Has the applicant ever suffered from any dis- E ho ease of the circulatory system? If yes, de- scribe. IV. The Nervous System. IV. no Has there ever been or is there any disease or functional derangement of the brain or other parts of the nervous system? If yes, state particulars. Inquire particularly regarding headaches, insomnia, nervous exhaustion, chorea or epilepsy and insanity. V. The Digestive System. V. Has the applicant any disease or functional de- rangement? ho A. Of the stomach ? A B. Of the intestines? B no C. Of the liver? C no D. Has there been or is there any tendency to D ho chronic constipation ? E. To diarrhea? E no 2232

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    "ocrText": "BEORO 038 MADIR3MA\nD. Has the applicant ever suffered from any disease\nD no\nor functional derangement of the respiratory\nsystem ? If yes, state particulars.\nmenimex3\nto\n35 inche\nE. What is the chest circumferecnce?\nE\nUpon full inspiration ?\n3> niches\n33 wich\nUpon full expiration?\nIII. The Circulatory System.\nA. What is the temperature of the body? (If\nIII. A\n98.6\nover 99° in the mouth, try another day.)\nB. Give the rate and other qualities of the pulse.\nB\nRecord blood-pressure.\n72 120 pull refregeles\nW.\nC. Does it intermit, or become irregular or un-\nC\nno\nequal?\nto\nD. Does physical examination reveal anything\nD\nno\nwhatever abnormal in the conditions of the\nheart or blood vessels?\na\nE. Has the applicant ever suffered from any dis-\nE\nho\nease of the circulatory system? If yes, de-\nscribe.\nIV. The Nervous System.\nIV.\nno\nHas there ever been or is there any disease or\nfunctional derangement of the brain or other\nparts of the nervous system? If yes, state\nparticulars. Inquire particularly regarding\nheadaches, insomnia, nervous exhaustion,\nchorea or epilepsy and insanity.\nV. The Digestive System.\nV.\nHas the applicant any disease or functional de-\nrangement?\nho\nA. Of the stomach ?\nA\nB. Of the intestines?\nB\nno\nC. Of the liver?\nC\nno\nD. Has there been or is there any tendency to\nD\nho\nchronic constipation ?\nE. To diarrhea?\nE\nno\n2232"
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