London's Pulse: Medical Officer of Health reports 1848-1972

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Leyton 1909

[Report of the Medical Officer of Health for Leyton]

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162
Leyton Urban District Council, Education Committee.
SCHEDULE OF MEDICAL INSPECTION.
I.—Name
(Surname first)
Date of Birth
Address
School
II.—Personal History:
(а) Previous Illnesses of Child (before Admission)
Measles Scarlet Fever
Whooping Cough Diphtheria..
Chickenpox Other Illnesses
(b) Family Medical History (if exceptional)
General Observations.
Directions to Parent or Teacher.