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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 ofticers: applicants for appointment as such in che Regular Army. National Guard, or Officers Reserve Corps and enrollment in the Reserve Otticers' Training Corps. Use typewriter if practicable. Attach plain additional sheets if required. 1. Whyte Catherine L. (Last name) (First name) (Middle initial) (Serial number) 2 Applicant for appointment Age 29 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 1 Last series August 19 41 5. Date of last smallpox vaccination August, 1941 Type of reaction Timmune 6. Other vaccination or immunity tests None 7. Medical history 3 Measles, Chicken-pox in childhood. Appendectomy, 1929. Tonsils & Adenoids, 1915. No hisbory 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 (Jaeger type) Left J# 1 correctible to J# by 4 Refraction (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 11. Teeth: 7 Right (Examinee's) PA 8 x x 4 3 2 1 1 2 3 4 5(8 Y) Indicate: Restorable carious teeth by o; nonrestorable carious teeth by /: missing natural teeth by X. 16 15 14 13 12 11 10 9 9 10 11 12 13 15 16 Remarks, including other defects None Classification IV Prosthetic dental appliances Serviceable 12. Posture Good Figure Slender Frame Medium (Excellent, good. fair, bad) (Slender. medium, stocky, obese) (Light, medium, heavy) 13. Temperature 97.8 Height 7Obinches. Weight 54pounds. Chest; Rest 33 inches; inspiration 362inches: expiration 32 inches. Abdomen. 31 inches. 14, Cardiovascular system Heart Normal Blood pressure : S. 90 D. 60 Pulse : Rate-Sitting 80 Immediately after exercise. 112 Two minutes after exercise 84 Character Full & regular Arteries Normal Varicose veins None 15. Respiratory system Normal 16. X-ray of chest 8 Calcified glands rt. hilar region: No evidence of recent activity. 17. Skin and lymphatics Normal Endocrine system Normal 18. Bones, joints, and muscles Normal Feet Normal 19. Abdominal viscera Normal 20. Hernia None Hemorrhoids None Appointment. promotion retirement. annual. active duty, special. Regular Army National Guard Officer Reserve Corps: Reserve Officer's Training Corps. If annual physical examination, record only for past year. If annual physical examination. record only distant and near vision, and state whether defect is properly corrected. When indicated. Not required for annual physical examination. If rejected for appointment in Regular Army because of malocclusion send plaster models to the Surgeon General 8 Required for candidates for commission. w.D., A.G O. FORM NO.63 16-10006 REPRODUCED HQ. s.o.s. E.T.O.

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    "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 ofticers: applicants for appointment as such in\nche Regular Army. National Guard, or Officers Reserve Corps and enrollment in the Reserve Otticers' Training Corps. Use typewriter if practicable. Attach plain additional\nsheets if required.\n1. Whyte\nCatherine\nL.\n(Last name)\n(First name)\n(Middle initial)\n(Serial number)\n2 Applicant for appointment\nAge\n29\nYears of service\n-\n(Grade)\n(Organization and arm or service)\n(Nearest birthday)\n(Whole number only)\n3. Nature of examination 1 Appointment\nComponent of Army 2 Army of U. S.\n4. Typhoid vaccination. No. series completed\n1\nLast series\nAugust\n19 41\n5. Date of last smallpox vaccination\nAugust, 1941\nType of reaction\nTimmune\n6. Other vaccination or immunity tests\nNone\n7. Medical history 3 Measles, Chicken-pox in childhood. Appendectomy, 1929.\nTonsils & Adenoids, 1915.\nNo hisbory of Asthma, Hay fever or Rheumatic fever.\n8. Eyes\nNormal\nDistant vision : Right 20/\n20\ncorrectible to 20/\nby 4\n(Snellen type) left 20/\n20\ncorrectible to 20/\nby 4\nNear vision Right J#\n1\ncorrectible to J#\nby 4\n(Jaeger type) Left J#\n1\ncorrectible to J#\nby 4\nRefraction (under cycloplegic) : Right\nNot done\nLeft\nNot 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\n11. Teeth: 7\nRight\n(Examinee's)\nPA\n8\nx\nx\n4 3 2 1 1 2 3 4 5(8 Y)\nIndicate: Restorable carious teeth by o; nonrestorable carious\nteeth by /: missing natural teeth by X.\n16 15 14 13 12 11 10 9 9 10 11 12 13\n15\n16\nRemarks, including other defects\nNone\nClassification\nIV\nProsthetic dental appliances\nServiceable\n12. Posture Good\nFigure\nSlender\nFrame\nMedium\n(Excellent, good. fair, bad)\n(Slender. medium, stocky, obese)\n(Light, medium, heavy)\n13. Temperature 97.8 Height 7Obinches. Weight 54pounds. Chest; Rest 33 inches; inspiration 362inches:\nexpiration 32 inches. Abdomen. 31 inches.\n14, Cardiovascular system Heart\nNormal\nBlood pressure : S.\n90\nD.\n60\nPulse : Rate-Sitting\n80 Immediately after exercise. 112\nTwo minutes after exercise\n84\nCharacter Full & regular\nArteries\nNormal\nVaricose veins\nNone\n15. Respiratory system\nNormal\n16. X-ray of chest 8 Calcified glands rt. hilar region: No evidence of recent activity.\n17. Skin and lymphatics\nNormal\nEndocrine system\nNormal\n18. Bones, joints, and muscles\nNormal\nFeet\nNormal\n19. Abdominal viscera\nNormal\n20. Hernia\nNone\nHemorrhoids\nNone\nAppointment. promotion retirement. annual. active duty, special.\nRegular Army National Guard Officer Reserve Corps: Reserve Officer's Training Corps.\nIf annual physical examination, record only for past year.\nIf\nannual physical examination. record only distant and near vision, and state whether defect is properly corrected.\nWhen indicated.\nNot required for annual physical examination.\nIf rejected for appointment in Regular Army because of malocclusion send plaster models to the Surgeon General\n8\nRequired for candidates for commission.\nw.D., A.G O. FORM NO.63\n16-10006\nREPRODUCED\nHQ. s.o.s. E.T.O."
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