Case 9627

St. Nicholas Home for Crippled Children,
Byfleet, Near Weybridge.

Medical Certificate

1. Child's name

J Elm Grove Newport I.S.

2. Age

7 years

3. Nature of Disease

Congenital paralysis

4. Duration, and whether active or stationary

Was treated in Orthopaedic Hospital about two years ago. ever since has been able to [?] and [?] progress with crutches

5. Is the child hopelessly crippled so that it cannot be trained to earn its living?

Probably the limit of impairment has been reached, but complications may develop [?] as he grows. Sharp and quick in [?]

6. Has the child any affection of the limbs, joints, skin or eyes which may have the effect of preventing it from entering domestic service

Only [?]

7. Is the child subject to fits? or has it ever had one? if so, state its nature.
Is the child subject to incontinence of urine?

no
no

8. Is the child at present affected with any infections or contagious disease, such as ringworm, &c., or with scrofula, requiring medical treatment?

no

9. Has the child had scarlet fever or whooping cough, measles, or small pox? If not the latter, has it been vaccinated?

Has had measles only of the epidemic diseases. Has been vaccinated

10. Is the child's general health good?

yes

Signature G

Qualifications M.D. [?]

Address [Cavisbrook], I. Wight

Date May 7th, 1903.