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Created by general-english-image-caption-blip on 2025-05-29

a photograph of a black and white document with a list of items in it

Created by general-english-image-caption-blip-2 on 2025-07-06

a sheet with the name of a school in the middle

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

This image is a blank form titled "School Physician’s Daily Report" issued by the Board of Health, Fitchburg, under its Division of School Inspection. It is designed for recording medical evaluations and observations in schools.

Layout:

1. Header:

   • Contains sections for the date ("Date 191") and general school information, including "School," "School Physician," and "District."

2. Left-hand Columns:

   • Listings for "Time (Arrival/Dept.)," "Room," and "Teacher."

3. Central Table: "Exclusions":

   • A chart labeled Exclusions, with columns for various medical conditions and diseases. These include:
     • Diphtheria
     • Scarlet Fever
     • Chicken Pox
     • Measles
     • Whooping Cough
     • Mumps
     • Acute Tonsillitis
     • Influenza
     • Syphilis
     • Scabies
     • Tuberculosis
     • Reference to school hygiene issues such as physical examinations and cleanliness
   • Rows are left blank for filling in data about affected students.

4. "Found Among Absentees" Section:

   • This area allows for the recording of:
     • Room
     • Name
     • Address
     • Disease
     • Age
     • Action Taken

5. Footer:

   • Includes additional fields for noting physical and mental defects:
     • Defects: Hearing, Vision, Teeth.
     • Issues like Poor Nutrition, Orthopedic Defects, Nervous Diseases, Adenoids, Tonsils.
     • Space for remarks, along with categories such as vaccinations and sanitary conditions (e.g., clean/fair/need attention).
     • Reinspection and actions for readmitted students or communication with parents.

Purpose:

The form was intended to track and manage student health, monitor diseases, and ensure proper action was taken, possibly during a time when public health efforts were crucial in schools (e.g., early 20th century). It reflects a structured approach to medical oversight in educational settings.

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

The image is of a form titled "BOARD OF HEALTH, Fitchburg. DIVISION OF SCHOOL INSPECTION. SCHOOL PHYSICIAN’S DAILY REPORT." This form, from the early 20th century, is designed for school physicians to track the health statuses of students on a daily basis.

At the top of the form, there are spaces to fill in the Date and the name of the School, along with the school physician's district. Below, there is a section for general information including the time (arrival and departure), room, and teacher.

The central part of the form includes a table labeled "EXCLUSIONS," listing various diseases and conditions that would warrant exclusion from school. These include infectious diseases like diphtheria and scarlet fever, conditions like whooping cough, and categories such as "mental defects" and "orthopedic defects."

There is also an area at the bottom labeled "Found among absentees," with columns for room, name, address, disease, age, and action taken, to document students who were absent due to health reasons.

At the very bottom, there's space for remarks, including notes for defects in hearing, vision, and teeth, as well as notes on poor nutrition, nervous diseases, vaccinations, reinspection, and sanitary conditions.

Created by anthropic.claude-3-haiku-20240307-v1:0 on 2025-06-14

This image appears to be a school physician's daily report form from the Board of Health in Fitchburg. The form is used to record various exclusions and health-related information about students, including details about their physical condition, any diseases or defects, and any actions taken. The form has columns for recording the time, room, teacher, and various types of exclusions or health issues, such as defects in hearing, vision, teeth, and nutrition. There is also a section for recording any absences and the names, addresses, diseases, ages, and actions taken for those students.

Created by us.anthropic.claude-3-opus-20240229-v1:0 on 2025-06-14

The image shows a school physician's daily report form from the Board of Health in Fitchburg in 1911. The form has a grid to track various health exclusions and issues found among absentee students, such as defect vision, nervous diseases, refractive errors, miscellaneous diseases, defect teeth, mental defects, readmittances, adenoids, orthopedic defects, and tonsils. There is also space at the bottom to record details about any students found among the absentees, including their name, address, disease, age, and action taken.

Created by us.anthropic.claude-3-5-sonnet-20241022-v2:0 on 2025-06-14

This is a historical medical form from the Board of Health in Fitchburg, specifically a "School Physician's Daily Report" from the Division of School Inspection. The form appears to be from the early 1900s (191_ is partially visible at the top).

The form is divided into several sections:

1. A top portion for recording basic information like date, school, time, room, and teacher
2. A large grid section labeled "EXCLUSIONS" with multiple columns for tracking various medical conditions
3. A bottom section titled "Found among absentees" with columns for Room, Name, Address, Disease, Age, and Action Taken

At the very bottom of the form, there are categories listed including:

• Defect, Hearing
• Poor Nutrition
• No Disease
• Vaccinations
• Defect Vision
• Nervous Diseases
• Reinspections
• Defect Teeth
• Mental Defects
• Readmitted
• Sanitaries - clean, fair, need attention
• Adenoids
• Orthopedic Defects
• Tonsilitis

This form was likely used to track student health and medical issues in the school system, allowing school physicians to document and monitor various health conditions and take appropriate action when necessary.

Created by us.meta.llama3-2-11b-instruct-v1:0 on 2025-06-01

The image depicts a vintage "School Physician's Daily Report" form, titled "BOARD OF HEALTH, Fitchburg" at the top, with the subtitle "DIVISION OF SCHOOL INSPECTION. SCHOOL PHYSICIAN'S DAILY REPORT." The form is dated 1911 and features a grid layout with various sections for recording information.

Key Sections:

• Arrival and Departure: Lists the names of students who arrived and departed the school on a given day.
• Exclusions: Records the reasons for which students were excluded from school, including illnesses such as scarlet fever, measles, and whooping cough.
• Total Found Among Absentees: Lists the number of students absent from school on a given day, categorized by room and reason for absence.
• Action Taken: Provides space for the school physician to note any actions taken in response to the absences or exclusions.

Additional Information:

• The form includes a section for recording the date, time, and room number of each student's arrival and departure.
• A table at the bottom of the page lists various diseases and defects, such as deafness, poor nutrition, and tonsils, with checkboxes for each condition.

Overall:

The image provides a glimpse into the daily operations of a school physician's office in the early 20th century, highlighting the importance of tracking student attendance and health issues. The form's layout and content suggest a focus on maintaining accurate records and ensuring the health and well-being of students.

Created by us.meta.llama3-2-90b-instruct-v1:0 on 2025-06-01

The image depicts a vintage school physician's daily report form, dated 191, from the Board of Health in Fitchburg. The form is designed to track student absences and health issues, with sections for recording the date, school, time of arrival and departure, room, teacher, and total number of students absent.

Exclusions Section:

• A table lists various diseases or conditions that may exclude a student from school, including:
  • Infectious diseases (e.g., diphtheria, scarlet fever, measles)
  • Skin conditions (e.g., impetigo, ringworm)
  • Respiratory issues (e.g., whooping cough, pneumonia)
  • Gastrointestinal problems (e.g., diarrhea, dysentery)
  • Other conditions (e.g., pediculosis, trachoma)

Total, Found among Absentees Section:

• A section for recording the total number of students absent due to each condition listed in the exclusions table

Additional Information Section:

• Spaces for recording additional information, such as:
  • Defects (e.g., hearing, vision, teeth)
  • Adenoids or orthopedic defects
  • Tonsils
  • Notes to parents

Remarks Section:

• A section for recording any additional remarks or comments related to the student's health or absence

Overall, this form provides a comprehensive way for school physicians to track student health and absences, helping to identify potential health issues and prevent the spread of diseases within the school community.

Created by amazon.nova-pro-v1:0 on 2025-05-31

The image is a document titled "BOARD OF HEALTH, Fitchburg. DIVISION OF SCHOOL INSPECTION. SCHOOL PHYSICIAN'S DAILY REPORT." The date at the top of the document is "191," which likely refers to the year 1910, although the exact year is not fully visible.

The document appears to be a form used by a school physician to report on the health status of students within a school setting. The form is divided into several sections:

1. Header Information:

   • "Date" is at the top left, followed by the year "191."
   • "School Physician, Dist." is on the top right.
   • "School" is on the left side, below the date.

2. Main Body:

   • The main body of the document is a table labeled "EXCLUSIONS."
   • The table has columns for various health-related exclusions, including:
     • "Diphtheria"
     • "Scarlet Fever"
     • "Measles"
     • "German Measles"
     • "Chicken Pox"
     • "Whooping Cough"
     • "Tuberculosis"
     • "Mumps"
     • "Pneumonia"
     • "Acute Tonsilitis"
     • "Influenza"
     • "Trachoma"
     • "Ringworm"
     • "Smallpox"
     • "Impetigo"
     • "Favus"
     • "Mumps (Parotitis)"
     • "Non-Vaccinations"
     • "Total Examinations"
     • "Physical Examinations"
     • "Physical Examinations Number Ill"
     • "Visits to Hospital"

3. Additional Sections:

   • Below the table, there are sections for recording:
     • "Time"
     • "Arrived"
     • "Departed"
     • "Room"
     • "Teacher"
   • There is a section for "Total" and "Found among absentees."

4. Individual Student Information:

   • There is a section for recording individual student details, including:
     • "Room"
     • "Name"
     • "Address"
     • "Disease"
     • "Age"
     • "Action Taken"

5. Remarks and Additional Notes:

   • There is a section labeled "REMARKS" at the bottom of the document.
   • Additional notes include categories such as "Defect. Hearing," "Defect. Vision," "Defect. Teeth," "Adenoids," "Tonsils," "Poor Nutrition," "Nervous Diseases," "Mental Defects," "Orthopedic Defects," "No Disease," "Reinspections," "Readmitted," "Notes to Parents," "Vaccinations," "Miscellaneous Diseases," and "Sanitation: clean, fair, need attention."

The document is a comprehensive record used by school physicians to monitor and report on the health conditions of students, ensuring that any necessary actions are taken to maintain the health and safety of the school population.

Created by amazon.nova-lite-v1:0 on 2025-05-31

The image is a historical document titled "BOARD OF HEALTH, Fitchburg." It is a SCHOOL PHYSICIAN'S DAILY REPORT from the Division of School Inspection. The document is dated 191, and it contains a table with various health-related categories for students, including their names, addresses, diseases, ages, and actions taken. The table includes columns for different health issues such as measles, whooping cough, tuberculosis, and others. The document also includes sections for remarks and notes to parents. The purpose of this document is to track and report on the health status of students in the school, likely for public health monitoring and intervention purposes.

Created by gemini-2.0-flash-lite on 2025-06-05

This is a vintage school health record form from Fitchburg, Massachusetts, titled "Board of Health, Division of School Inspection, School Physician's Daily Report". It's from the year 191, suggesting it is from the early 20th century.

Key Features:

• Heading: The form clearly states the board, division, and type of report.
• Exclusions: A section is dedicated to recording exclusions from school due to illnesses. The columns list various contagious diseases (diphtheria, measles, etc.) and other reasons for exclusion.
• Attendance/Inspection: There's a section to record the room number, teacher, and time of arrival/departure.
• Absentee Information: Information regarding students absent from school, including their name, address, disease, age, and action taken.
• Medical Information: A section for notes on various physical defects, nutritional issues, and other health-related information.
• Remarks: A space for additional remarks or notes.

Overall: This form provides a snapshot of how public health officials monitored the health and attendance of students in schools during that period.

Created by gemini-2.0-flash on 2025-06-05

Here's a description of the image:

The image shows a form titled "BOARD OF HEALTH, Fitchburg. DIVISION OF SCHOOL INSPECTION. SCHOOL PHYSICIAN'S DAILY REPORT." The form includes spaces for the date, school, school physician district, time (arrival and departure), room, teacher, and total. A large section is dedicated to exclusions, with columns for various diseases (Diphtheria, Scarlet Fever, Measles, German Measles, Chicken Pox, Whooping Cough, Mumps, Pulmonary Tuberculosis, Acute Tonsillitis, Influenza, Gonorrhea, Syphilis, Pediculosis, Trachoma, Acute or Purulent Conjunctivitis, Ringworm, Scabies, Impetigo, Favus, Molluscum Contagiosum, Non-Vaccination, and "For Other Cause"). Columns are also present for the number of inspections made, the total number of physical examinations, and the number of visits to homes.

Below this, there's a section for recording information about absentees, including their room, name, address, disease, age, and action taken. At the bottom of the form are lists of possible defects and remarks, including defects of hearing, poor nutrition, no disease, vaccinations, defects of vision, nervous diseases, reinspections, miscellaneous diseases, defects of teeth, mental defects, readmitted students, sanitaries (with a note about cleanliness), adenoids, orthopedic defects, notes to parents, and tonsils.

Created by us.mistral.pixtral-large-2502-v1:0 on 2025-06-03

The image is a historical document titled "School Physician's Daily Report" from the Board of Health, Fitchburg, Division of School Inspection. The document appears to be a form used by school physicians to record health-related observations and actions taken during their daily inspections of students.

The form is divided into several sections:

1. Header Information:

   • Date: A space to fill in the date.
   • School: A space to fill in the school name.
   • School Physician, District: A space to fill in the name of the school physician and the district.

2. Exclusions Section:

   • This section is a table with columns for:
     • Time of Arrival and Department.
     • Room and Teacher.
     • Various health conditions or reasons for exclusion, such as:
       • Impetigo
       • Diphtheria
       • Scarlet Fever
       • Measles
       • German Measles
       • Chicken Pox
       • Whooping Cough
       • Mumps
       • Poliomyelitis
       • Acute Tonsillitis
       • Influenza
       • Pneumonia
       • Tuberculosis
       • Syphilis
       • Gonorrhea
       • Trachoma
       • Acute Gastroenteritis
       • Ringworm
       • Pediculosis
       • Scabies
       • Impetigo
       • Favus
       • Malnutrition
       • Dehydration
       • For Other Cause
       • Ear Disease
       • Physical Examinations
       • Visit to Homes

3. Total Section:

   • A line to record the total number of exclusions.

4. Found Among Absentees Section:

   • This section is a table with columns for:
     • Room
     • Name
     • Address
     • Disease
     • Age
     • Action Taken

5. Footer Information:

   • A list of various health-related categories for further notes or observations, such as:
     • Defects in Hearing, Vision, Teeth
     • Poor Nutrition
     • No Disease
     • Vaccinations
     • Nervous Diseases
     • Mental Defects
     • Orthopedic Defects
     • Adenoids
     • Tonsils
     • Reinspections
     • Miscellaneous Diseases
     • Readmitted
     • Sanitaries: clean, fair, need attention
     • Notes to Parents
     • Remarks

The form is designed to systematically document the health status of students, track any diseases or conditions, and record actions taken by the school physician. This helps in monitoring and managing the health of the school population effectively.

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