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Anthropometric tests-Continued. Observations... (6) Precision tests: Right hand.. left

hand. Sensory tests:

Visual acuity: Right eye. ; left eye.
Observations....
Auditory acuity: Right ear. .; left ear..
Observations..

Pressure threshold..

Aesthesiometric threshold... Perception tests: (a) Size: (1) Dermo-muscular ......; (2) mus-.

cular....
(0) Form: (1) Münsterberg's touch exp

(2) Jastrow's sorting exp...
(c) Weight:(1) Active.......; (2) passive
(d) Time:
(e) Brightness: Sorting of grays
U) Color: (1) Least perceptible difference (reds)

(2) sorting colors..
(0) Movement:
(h) Symbols: Marking out “A's".
Total time..

-; Accuracy
Motor time.

Finding time.
Association:

Color-numeral.
Symbol-numeral.
Part-whole..

(a) Simple..

(6) Complex... Attention:

Natural....

With distraction..
Memory tests:
(a) Immediate sense-

1. Numerals seen......
2. Numerals seen and spoken.
3. Words seen...
4. Words seen and spoken.
5. Objects seen..
6. Objects seen and names spoken
7. Numerals heard..
8. Numerals heard and spoken..
9. Words heard........
10. Words heard and spoken.

11. Smells...
(0) Associational-simple.
(c) Logical......

Growths-Continued.

Cranial asymmetry.
Forehead retreating.
Foorehead narrow
Forehead low..
Facial asymmetry: Forehead.. ; nose

eyes....; ears....; mouth parts.
Ears deformed.
Dentition: Teeth irregular. ..; doubled....

serrated....; pointed....; chalky.
Palpebral fissures small..
Nasal bones sunken...
Adenoidic....
Mouth breathing.
Palate: Narrow.

high.

asymmetrical.. Tongue: Thick....; flat....; pointed....; fur

rowed......; papillae hypertrophied..

coated. Movement:

Sluggish.
Restless.
Incoordinated.
General balance relaxed.
Asymmetrical posture...
Asymmetrical head balance.
Overaction of frontals
Corrugation.....
Incoordination of eyes..
Relaxed orbicularis oculi.
Hand balance: Asymmetrical.

Tense.
Relaxed.

Drooped.
Finger twitchings.
Eyelid twitchings.

Tongue twitchings.
Defective speech:
Hesitation..

.; lisping.. Stammering. -; stuttering.

Improper pronunciation of.. General observations on mental action:

Judgment erratic......; mind wandering ....

cholic......; choleric......; sanguine.....
phlegmatic......; sullen......; silly..
face immobile......; timid. ; bold.....;
curious......; indifferent......; affection-

ate......; repellant...
Sensitivity: Good....; fair....; poor....
Perceptive ability: Good...; fair...; poor...
Memory: Good....; fair....; poor ..
Ability to reason: Good..; fair....; poor....
Mental prognosis: Good..; fair....; poor.....
Is able to work with number combinations to..
Is able to read well-fairly well--poorly-lesson

..... in the... ...reader.

OBSERVATIONS. Growth:

Obese..
Emaciated...
Bilateral asymmetry
Deformities..
Scoliosis.
Lordosis..
Chest sunken.
Hydrocephalic.
Microcephalic.

REMARKS AND RECOMMENDATIONS.

NEWARK, N. J.

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BOARD OF EDUCATION, NEWARK, N J.

.School To parents and guardians:

To protect the health and to secure the proper development of the child's body, the school law of the State of New Jersey and the rules and regulations of the board of education of the city of Newark require all public-school pupils to be examined by the school physician, to learn whether they have any defects of the eyes, ears, nose, throat, heart, or lungs.

To make a thorough examination of the heart and lungs it is usually necessary to remove all or a part of the clothing which covers the chest and back. This is done by the school physician with the least possible exposure of the body. In case boys or girls are timid or sensitive, they will be examined alone in the doctor's office, provided the parent wishes it In case of girls, clothing will not be removed except in the presence of a woman, mother, nurse, teacher, or clerk. Mothers are invited to be present at the examination is they desire.

Examinations of this kind are now quite common in all the cities of the country that are taking measures to protect the health and to improve the condition of school children.

Please state below, in the manner directed, whether you wish your child examined under the above conditions.

Principal. Dated.....

(Parent will please fill out and return.) I wish my child (children) examined by the school physician as above. Yes. No. (Cross out either yes or no.)

(Signed)

Parent or Guardian. In case no reply is received from you within two days, it is understood that you consent to having your child (children) examined.

DEPARTMENT OF MEDICAL INSPECTION, BOARD OF EDUCATION, NEWARK, N. J.

The following is a report of nurse No...

for..

191..

Causes for which pupils were treated.

Exclusions.

Schools visited.

Number of classes inspected.

Visits to homes.
Taken to dispensary

or physician.
Lectures delivered.

ness.
Examinations for uncleanli-
Old cases.
New cases.
(ured.
Old.
Now.
Old.
New.

Pediculosis.

Acute conjunctivitis.
Ringworm.
Scabies.
| Impetigo.
Molluscum con.
Eczema.
Favus.

Infected wounds.

Vaccination dressings.
Suspected contagious

diseases.
Others.
Total.

Pediculosis.

Uncleanliness. | Others.

Nurse.

BOARD OF EDUCATION, NEWARK, N. J.

WEEKLY WEIGHT RECORD,

Date.

Weight.

Gain or

loss.

Date.

Weight.

Gain or

loss.

Date.

Weigbt.

Gain or

loss.

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BOARD OF EDUCATION, NEWARK, N. J., DEPARTMENT OF MEDICAL INSPECTION:

PHYSICAL RECORD.

Name..

Age........ Address..
School.
...Grade.

19.. 1. Nutrition: Bad; good.

10. Defective nasal breathing: Yes; no. 2. Enlarged cervical gland: Yes; no. Anterior; 11. Teeth: Bad; good. posterior

12. Deformed palate: Yes; no. 3. Chorea: Yes; no.

13. Impediment in speech: Yes; no. 4. Cardiac disease: Yes; no.

14. Hypertrophied tonsils: Yes; no. 5. Pulmonary disease: Yes; no.

15. Posterior nasal growth: Yes; no. 6. Skin disease: Yes; no.

16. Mentality: Bad; good. 7. Deformed spine: Yes; no. Chest: Yes; no. 17. Treatment necessary: Yes; no. Extremities: Yes; no.

18. Nationality.. 8. Defective vision: Right eye; left eye.

19. Date of your inspection.. 9. Defective hearing: es; no.

20. Remarks.. Form 801 signed: Yes; no.

Medical Inspector No. ...... (On reverse side: Improvement noted on reexamination.)

BOARD OF EDUCATION,

Newark, N.J.,
The medical inspector of this school finds no evidence of successful vaccination on the person of..

In accordance with the rules of the board of education such evidence of successful vaccination is necessary or your child can not be admitted to school.

Please have your child vaccinated at once by your family physician; or, in case you wish your child vaccinated by the medical inspector (which will be done free of charge), sign your name in the space below and return this card at once.

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191..

NEWARK, N. J., The'

snurse has this day visited my classroom and examined pupils.
lphysician

(Signed)
(This notice must be sent to the principal the same day inspection is made.)

Teacher.

BOARD OF EDUCATION, NEWARK, N. J.,
Department of Medical Inspection,

191... Principal

School.
residing at

is granted a permit to attend

.school beginning

provided an examination by the medical inspector on his her) arrival discloses no evidence of disease.

Supervisor of Medical Inspection.

BOARD OF EDUCATION, NEWARK, N. J., DEPARTMENT OF MEDICAL INSPECTION.

Examined in Supervisor's Office.
Accompanied by..

Date.
Name,
Address,

Newark, N. J.
School

Grade.....
Age.

Vaccination inspection
Family history:
Mother's name.
Father's name.

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Newark, N.J., .....

.19....

.at...... The parent or guardian of..... is hereby informed that a physical examination by the Medical Inspector seems to show the following abnormal condition:

You are requested to take this child and the card to your family physician or clinic for advice and treatment.

Medical inspector,... GEO. J. HOLMES, M. D.,

Supervisor of Medical Inspection. (Filled out on reverse side by pbysician.)

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