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Blank No.33 Series II Form B. 5.

11- Menstruation:
First menstruation at what age? And when thoroughly established:
1st menstruation at 15. For first year it recurred every 3 weeks, and then became thoroughly established every 4 weeks.

Present condition as regards menstruation
(a)how frequent? every four weeks
(b)is it regular or not? quite regular, never varies more than a day or so.
(c) amount? how many napkins? copious - 6 napkins saturated.
(d) duration? 7 or 8 days.
(e) pain or not? at what times as to the flow,
seldom any pain whatever
(f)is there any leucorrhoea (white)? character?
A little white in color. Comes during week following menstruation.
Amount? Slight
Constant or occassional? Occassional
(g)have you pain either frequently or habitually in the head, small of the back? Abdomen or limbs? No
Have you ever had any pelvic trouble and had to go to a physician? When and what was it? No
(h)disease or trouble in uterus (womb) or other pelvic organs? None.
(i)habit of bowels; how often? Regular, every day once