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Created by general-english-image-caption-blip on 2025-05-17

a photograph of a pink paper receipt with a picture of a child's birth certificate

Created by general-english-image-caption-blip-2 on 2025-07-05

a pink form with a number on it

Created by gpt-4o-2024-11-20 on 2025-06-11

This image shows a bright pink medical or public health form. The form contains printed fields that require information about an individual, likely for a health-related report or investigation. The fields include:

• Residence
• Name
• Age (with spaces for both years and months)
• Date of Report (with the year prefilled as "19")
• Date of First Symptoms
• Whom Reported By
• Cause of Disease
• Number in Family
• Number of Adults
• Number in School
• School
• Milk Supply
• Disinfected

At the bottom of the form, there is a small note indicating the manufacturer: "YAWMAN & ERBE MFG. CO., ROCHESTER AND BOSTON." A product number and the abbreviation "3000" appear beside it.

The card seems designed for documenting disease cases or gathering epidemiological data during an earlier period, potentially for monitoring infection sources and household details.

Created by gpt-4o-2024-08-06 on 2025-06-11

The image shows a vintage medical report form printed on pink paper. The form includes fields for various pieces of information, including:

• Residence
• Name
• Age, with subfields for Years and Months
• Date of Report (with the year partially filled as "19__")
• Date of First Symptoms
• Whom Reported By
• Cause of Disease
• No. in Family
• No. Adults
• No. in School
• School
• Milk Supply
• Disinfected

At the bottom of the form, in small text, it reads "YAWMAN & ERBE MFG. CO., ROCHESTER AND BOSTON" along with numbers "23514" and "3000," and "3 00". The form is blank, with no information filled in any of the fields.

Created by anthropic.claude-3-haiku-20240307-v1:0 on 2025-06-17

The image appears to be a medical or health-related form or document. It contains various fields and sections for recording information about a person's residence, name, age, date of first symptoms, cause of disease, family information, school attendance, milk supply, and whether the area has been disinfected. The form is printed on a bright pink background, which is likely used to make it stand out or be easily identifiable.

Created by us.anthropic.claude-3-opus-20240229-v1:0 on 2025-06-17

The image shows a form titled "Residence" with various fields filled out. It appears to be a report about an individual's disease, including their age (19 years), date of first symptoms, number of family members and adults affected, school attended (Milk Supply), and that the premises were disinfected. The form was printed by Yawman & Erbe Mfg. Co., Rochester and Boston.

Created by us.anthropic.claude-3-5-sonnet-20241022-v2:0 on 2025-06-17

This image shows a pink medical or health report form from Yawman & Ebbe Mfg. Co. (based in Rochester and Boston). The form appears to be vintage and includes several fields to be filled out, including:

• Residence
• Name
• Age (with spaces for Years and Months)
• Date of Report (with "19" pre-printed)
• Date of First Symptoms
• Whom Reported By
• Cause of Disease
• No. in Family
• No. Adults
• No. in School
• School
• Milk Supply
• Disinfected

The form appears to be blank (unfilled) and was likely used for tracking disease or illness cases, possibly during an epidemic or for public health records. The pink color and formatting suggest this is likely from the early to mid-1900s.

Created by us.meta.llama3-2-11b-instruct-v1:0 on 2025-06-02

The image presents a pink card with black text, featuring a table with various columns and rows. The table is divided into sections, each containing specific information about an individual.

• Residence
  • The first section is labeled "Residence" and contains no data.
• Name
  • The second section is labeled "Name" and contains no data.
• Age
  • The third section is labeled "Age" and contains the value "19".
• Years
  • The fourth section is labeled "Years" and contains no data.
• Months
  • The fifth section is labeled "Months" and contains no data.
• Date of Report
  • The sixth section is labeled "Date of Report" and contains the value "19".
• Date of First Symptoms
  • The seventh section is labeled "Date of First Symptoms" and contains no data.
• Whom Reported By
  • The eighth section is labeled "Whom Reported By" and contains no data.
• Cause of Disease
  • The ninth section is labeled "Cause of Disease" and contains no data.
• No. in Family
  • The tenth section is labeled "No. in Family" and contains the value "No. Adults".
• No. in School
  • The eleventh section is labeled "No. in School" and contains the value "No. in School".
• School
  • The twelfth section is labeled "School" and contains the value "Milk Supply".
• Disinfected
  • The thirteenth section is labeled "Disinfected" and contains the value "Disinfected".

The image appears to be a form used to collect information about an individual's health, including their age, date of report, date of first symptoms, cause of disease, number of people in their family and school, school supply, and whether they have been disinfected.

Created by us.meta.llama3-2-90b-instruct-v1:0 on 2025-06-02

The image presents a pink card with black text, featuring a series of lines and sections that resemble a medical report or chart. The top-left corner displays the word "Residence," while the top-right corner remains blank. Below this, the card is divided into several sections, including:

• Name: A blank space for the patient's name.
• Age: A section to record the patient's age.
• Years: A column to note the number of years.
• Months: A column to note the number of months.
• Date of Report: A section to record the date of the report.
• 19: A number likely indicating the number of reports.
• Date of First Symptoms: A section to record the date of the first symptoms.
• Whom Reported By: A section to note who reported the symptoms.
• Cause of Disease: A section to record the cause of the disease.
• No. in Family: A section to note the number of people in the family.
• No. Adults: A section to note the number of adults.
• No. in School: A section to note the number of people in school.
• School: A section to note the school.
• Milk Supply: A section to note the milk supply.
• Disinfected: A section to note if the area has been disinfected.

At the bottom of the card, there is a line of text that reads "YAWMAN & ERBE MFG. CO., ROCHESTER AND BOSTON." Additionally, there are some numbers in the bottom-right corner, including "23514," "3000," and "3 00." These numbers may represent a catalog number or other identification code for the card.

Created by amazon.nova-lite-v1:0 on 2025-06-01

The image shows a pink-colored form with various text boxes. The top of the form reads "Residence" and "Name." Below that, there are boxes for "Age," "Years," "Months," and "Date of Report." The boxes for "Date of First Symptoms," "Whom Reported By," "Cause of Disease," "No. in Family," "No. Adults," and "No. in School" are blank. The boxes for "School," "Milk Supply," and "Disinfected" are also blank. The bottom of the form reads "YAWMAN & ERBE MFG. CO., ROCHESTER AND BOSTON." The number "22514" is written in the bottom right corner.

Created by amazon.nova-pro-v1:0 on 2025-06-01

The image shows a pink form with black text. The form has a structured layout with multiple fields, each labeled with specific information. The fields include "Residence," "Name," "Age," "Years," "Months," "Date of Report," "Date of First Symptoms," "Whom Reported By," "Cause of Disease," "No. in Family," "No. Adults," "No. in School," "School," "Milk Supply," and "Disinfected." The form is blank, with no information filled in, indicating that it is a template or a blank form ready to be filled out. The form's design suggests that it is intended for recording medical or health-related information, possibly for tracking cases of a specific disease or condition.

Created by gemini-2.0-flash on 2025-05-29

Here's a description of the image:

The image shows a pink or reddish card with text fields for recording information. It appears to be a form designed for collecting data related to a potential illness or health issue. The fields include:

• Residence
• Name
• Age (with separate fields for Years and Months)
• Date of Report (with "19" pre-printed)
• Date of First Symptoms
• Whom Reported By
• Cause of Disease
• No. in Family
• No. of Adults
• No. in School
• School
• Milk Supply
• Disinfected

The card is likely from the early to mid 20th century, given the font and style. The bottom text reads "YAWMAN & ERBE MFG. CO., ROCHESTER AND BOSTON" indicating the manufacturer or printing company. There is a number near the lower-right corner of the card.

Created by gemini-2.0-flash-lite on 2025-05-29

Here is a description of the image:

The image shows a vintage pink card, likely used for recording public health information. The card is divided into sections with labeled fields.

• The top sections ask for "Residence," and "Name".
• Following that, it has "Age", "Years", "Months," and "Date of Report" with a number "19" at the end.
• There is a section to record "Date of First Symptoms" and "Whom Reported By".
• Other fields are for "Cause of Disease," "No. in Family", "No. Adults", and "No. in School".
• The card also has fields for "School," "Milk Supply," and "Disinfected".
• At the bottom of the card it says "YAWMAN & ERBE MFG. CO., ROCHESTER AND BOSTON" .
• On the right-bottom corner, the card is marked with numbers "23514 3000 3 00" .

Overall, the card is a record-keeping tool, indicating a concern with tracking information related to health, school, family, and disease, with the purpose to document and monitor health-related information.

Created by us.mistral.pixtral-large-2502-v1:0 on 2025-06-04

This image appears to be a historical medical report form, likely used to document cases of infectious diseases. Here is a detailed summary of the fields on the form:

1. Residence: A blank space for recording the patient's address.
2. Name: A blank space for recording the patient's name.
3. Age:
   • Years: A blank space for recording the patient's age in years.
   • Months: A blank space for recording the patient's age in months.
   • Date of Report: The date the report was filed, which is partially filled in with the day "19."
4. Date of First Symptoms: A blank space for recording the date when the patient first exhibited symptoms.
5. Whom Reported By: A blank space for recording the name of the person who reported the case.
6. Cause of Disease: A blank space for recording the suspected cause or source of the disease.
7. No. in Family: A blank space for recording the number of family members affected.
8. No. Adults: A blank space for recording the number of adults affected.
9. No. in School: A blank space for recording the number of individuals in school affected.
10. School: A blank space for recording the name of the school if applicable.
11. Milk Supply: A blank space for recording details about the milk supply, which might be relevant if the disease is suspected to be related to contaminated milk.
12. Disinfected: A blank space for recording whether disinfection measures were taken.

At the bottom of the form, it is printed: "YAWMAN & ERBE MFG. CO., ROCHESTER AND BOSTON." This suggests that the form was produced by Yawman & Erbe Manufacturing Company, which was based in Rochester and Boston. The form also has a sequence number "23514" and a year "1900," indicating it was used around the year 1900.

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