The Making of a Man: Being a Description of Artificial Limbs and How They May Be Adopted by Those Who Have Suffered Loss of Their Natural Limbs

by N.Y.) George R. Fuller Co. (Rochester

4. State

5. Age

6. Weight

7. Height

8. Occupation

9. Leg or arm amputated

10. When amputated

11. Right or left

12. Above or below elbow or knee

13. If above, give length from body