Case 6024

Medical Certificate

Name of Candidate A.
Age next Birthday 16 years
Is she a Cripple? No.

Questions to be answered by Medical Referees*, and to be forwarded to
Arthur B. Carpenter, Esq., M.D., "Wykeham House," Bedford Park, Croydon, Surrey.

1. In what part is she crippled?

None.

2. By what disease or injury?

None.

3. Does diseased action continue?

--

4. Is her present crippled state due to a persistent disease or is it merely the result of a past disease? In the latter case how long is it since morbid action ceased?

None.

5. Has she any wound?

No.

6. Is she perfectly sound in mind?

Displays [?] because of considerable mental deficiency possibly due to very prolonged ill usage during childhood.

7. Is she affected with hydrocephalus?

No.

8. Has she any symptoms of [cretinism]?

No.

9. Are her sight and hearing good? If impaired, to what extent?

No.

10. Is she affected with chorea, epilepsy, or other violent nervous afflictions?

No.

11. Is there any paralysis? If so, of what limbs? Is it total or partial?

No.

12. Has she the use of both her hands and fingers? If impaired to what extend? Can she sew?

Has recently had a [?], which has rendered right finger rather stiff, but they will probably become perfectly useful. otherwise quite normal as [?] hand.

13/ Are there any symptoms of phthisis? If so, is it in the second or third stage? Any spitting of blood? What physical signs?

No.

14. Has she tabes [?]? If so, how long has it persisted? In what stage is it?

No.

15. Has she incontinence of both or either of the chief excretions?

occasionally wets bed & is dirty, during the day & apparently unconsciously

16. Has she now or has she recently had any contagious disease? If so, the state of recovery? Any [?] present?

No.

17. Does she require help in dressing or in going from place to place?

No.

18. Is she in fit health to learn a sedentary handiwork?

Yes.

Signature of Medical Referee W
Address Earlgate E. Croydon
Date Apl 5th 1894

*Medical fees required for examinations made out of the Institution must be paid by the friends of the Candidate.