1949-1950 Baptist Bible Institute Catalog

PHYSICIAN'S CERTIFICATE of APPLICANT'S HEALTH EXAMINATION BAPTIST BIBLE INSTITUTE 8273 HOUGH AVE. CLEVELAND 3, OHIO Date______ ______ Name of Applicant Ears- Righ Left____ Nose___ ~ Thro~---- Teeth Eyes___ Does applicant wear glasses___ Reading only eart___ Murmurs Pulse.___ Lungs -------------------------- P.M.H. :Chicken po Measles_ Whooping cough__ Diphtheri Scarlet Fever Infantile Paralysis Pneumoni....____ Is the applicant subject to sore throat Common colds____ Headache Tuberculosis Rheumatic Fever___ Dysmenorrhea____ Is it necessary for the applicant to take any medications for any of the above conditions? If so state Describe, if any, special weaknesses or limitations; abnormalities ; injuries : ------------------------- This is to certify that is mentally fit ( ) and physically fit ( ) fo r the demands of unfit ( ) 1r:1fit ( ) s t udent life in The Baptist Bible Instit ute, 8273 H ough Ave., Cleveland 3, Ohio NOTE We realize the busy days of a Doctor a nd the many de– mands upon his time but the Doctor's expert opinion means much t o us, and we fully appreciate your prof ssional court sy and kindn ss in filling out and returning this c rtificate. Thank you. License numb r Signed Addr ss _ M.D . B .B.I. , orm 102