199

Blank No. Series II. Form B. 5.
[in margin]23.[in margin]
11 - Menstruation:
First menstruation at what age? and when thoroughly established?
about 14 yrs. - doesn't [??]
Present condition as regards menstruation - ceased 1912 when
48
a) how frequent? 28-35 days
b) is it regular or not? fairly reg. within those limits
c) amount? how many napkins? moderately
e) duration? 7(3)
e) pain or not? at what time as to the flow,
mod. pain few hrs. at the beginning.
f) is there any leucorrhoea (whites)? character? considerable
amount? considerable
constant or occasional? ?
g) have you pain either frequently or habitually in the
head, small of the back? abdomen or limbs?
h) disease or trouble in Uterus (womb) or other pelvic organs?
displacement which yielded to treatment after
her heavy clothes were supported. 84-5 trouble in
86-7 many new & fine clothes in latest fashion

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