Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for East Ham]
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Name | Date of Birth | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Surname first). | |||||||||||||||||
School | Date of leaving School | ||||||||||||||||
Date of admission | |||||||||||||||||
Scarlet Fever. | Diphtheria. | . Measles. | | Whooping Cough. | Chicken Pox. | Mumps. | Rheumatic Fever. | |||||||||||
Date of Illnesses | |||||||||||||||||
Year | 19 | 19 | 19 | 19 | 19 | 19...... | 19...... | 19...... | 19...... | 19...... | |||||||
Actual at tendances | |||||||||||||||||
Possible attendances | . | ||||||||||||||||
Family History (if exceptional) | Directions to Parents or Teachers | General Observations. | |||||||||||||||
Occupation | F. | I | |||||||||||||||
M | |||||||||||||||||
* Total Number of | Rooms | Families | Adults Children | II | |||||||||||||
Consumption on Fathers side ? | III | ||||||||||||||||
Do. on Mother's side ? | |||||||||||||||||
Work before or after School. | Nature | IV | |||||||||||||||
Duration |