school record form

Pre-printed red grid school health education record form issued by the Board of Education of the City of New York for girls’ high schools. The form is titled « BOARD OF EDUCATION OF THE CITY OF NEW YORK / HEALTH EDUCATION — GIRLS / HIGH SCHOOL » and records physical examination observations, health service data, and activity classifications. It is filled out in black/blue ink and pencil for a student named « Dolores A. » with physical metrics recorded (e.g., hair: Brown, height: 61, weight: 136). The form includes boxed handwritten annotations listing « Monica Burns » and « John Silver », as well as « No H. Ed. in block program! ».