258 MEMOIRS NATIONAL ACADEMY OF SCIENCES. rrouxv. 



CONFIDENTIAL. The publication or reproduction of this document Isforbidden 

 by the terms of the Espienage Act of June 15. 1917, under penalty of a fine of not 

 more than $10,000 or imprisonment of not more than two years, or both. 



FORM O GROUP EXAMINATION BETA GROUP NO 



Name _ Rank Age. — 



Company Regiment _ Arm Division — 



In what country or state born ? ....„ ;._ Years in U. S. ? _ Race - 



Occupation - Weekly Wages. 



Schooling: Grades, 1,2, 3,4,5,6,7,8: High or Prep. School, Year 1, 2,3,4: College, Year 1,2, 3, 4. 



TEST 8 



1. & 3. 4. 



5. 



6. 



7. 



— I, ■■!■■ — 



a 



a 



10. 



li 



12. 



Division Qf Psychology, Medical Department, U. S. A. 

 Authorised by the Surgeon General. Feb. 8, 1918. Edition, July 10. 1918, 300.000 



Fig. 55.— Group Examination Beta, Form 0, Test 8, Spot Pattern. 



