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116
LAMBETH MATERNITY AND CHILD WELFARE SCHEME
PUBLIC HEALTH DEPARTMENT
(d)
Welfare Centre
Name Date of Birth
(Surname first)
Address (1)
(2 )
(3 )
II. Personal History (a)* Previous illnesses of child:—
Measles Scarlet Fever Diphtheria
Whooping Cough Chicken Pox Mumps
Other Illnesses
(b) Family Medical History (if relevant)
(c) Whether immunised against Diphtheria or not
III. Dental Inspection:—
Date Dental Officer's Reports
Minor Ailments Treated.*
Date Ailment Hospital
Remedial Exercises and Other Matters.
e.g., Special Diets, etc., and general mental and physical development.
Date
Name of School Date of entry
* To be kept up-to-date as child attends.
Th is Card, together with any following-up card made out, to be returned to the Medical Officer of Health, when the child leaves the Centre or goes to school.
TODDLER'S RECORD CARD [P.T.O,