Manual for nutrition surveys / Interdepartmental Committee on Nutrition for National Defense.
- United States. Interdepartmental Committee on Nutrition for National Defense
- Date:
- 1957
Licence: Public Domain Mark
Credit: Manual for nutrition surveys / Interdepartmental Committee on Nutrition for National Defense. Source: Wellcome Collection.
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![DATE _CARD # ue LOCATION ACTIVITY oI NAME SEX LJ M[E]F SERIAL# UNIT TIME IN SERVICE Mh AREA OF ORIGIN ] RURAL AGE_ yr. HEIGHT =e Sin: WELGh eS b: STANDARD WEIGHT_______ % STD. WT. HUNDREDS CARD NUMBER (1ST 3 DIGITS) SUSPECTED DISEASE: CURRENT DISEASE: MALARIA (.] TRACHOMA 29 {_] DIARRHEA (J OTHER 4 . GENERAL APPEARANCE TONGUE 1 _] Good L Fair [_] Poor () Cachexia ] Filiform Papillary Atrophy CJ Slight [_] Moderate LD Severe 2 tor Ob q0018 a THOUSANDS HAIR (_] Fungiform Papillary Atrophy [_] Staring Hair - 4 0 66 (_] Papillary Hypertrophy or Hyperemia _] Depigmentation J Slight ] Moderate [5 Severe BANIWWX] a6 GLANDS 0 Furrows LOCATION ‘da 96 46 Thyroid Enlarged L) Fissures, erosions, or ulcers S6 (} Parotid Enlarged C) Bilateral LJ Serrations and Swellings W1L373S 16 Firm LC Soft Red, Tip and/or Lateral Margins Only [J Submaxillary Enlarged CJ Red, Scarlet, Beefy (Glossitis) t ACTIVITY 76 Magenta Colored SKIN — FACE & NECK 16 (_] Geographic Nasolabial Seborrhea 06 Other Seborrhea GUMS 68 Erythema _] Marginal Redness S3)LINGYL XG HIMOT a8 Pigmentation _] Marginal Swellings TIME IN SERVICE a 1] Atrophy of Papillae EYES 98 [_] Recession of Gums ) Thickened Conjunctiva s Bleeding Gums (Grade | (Grade I! % STO. WT A (Swollen red interdental [J Pingueculae Seaiutic MVS papillae) NaWOaaY va it) ( Bitot's Spots TEETH Unfilled Caries 1-2 J Circumcorneal Injection [) Conjunctival Injection GEN. APP. |DIAR. Caries 1-2 C) Blepharitis 6L (J Xerophthalmia HAIR ) Edentulous a2 IPS with plates no plates LL (J Angular Lesions (_] Worn ~WuaNaS — NIMS 9 GLANDS $l (J Cheilosis, General Malposition 1-4 : E 17-20 21-24 25-28 29-32 red 37-40 T T if 1 | | CARD NO. 30 32 | 37 39 afas a) St S3| 55 58) OL 6a 70 : wT. IsDiico 3, 33 36] 3a ao 41 aa | a7 50 ie Bi] Sz, 6s Cee aH SaAa INONOL SWND HigaL SKIN-FACE & NECK Ll sy 45 9S 4s 8S 6S £9 9 $9 99 19 #9 69](https://iiif.wellcomecollection.org/image/b32172783_0034.jp2/full/800%2C/0/default.jpg)
