APPENDIX 321 
This is to certify that, on the dates below indicated, offcial 
visits were made to the dairy, owned and conducted by 
of (indicating town and state), where careful 
inspections of the dairy employees were made. 
(a) Number and dates of visits since last report. ————. 
(6) Number of men employed on the plant. 
(c) Has a recent epidemic of contagion occurred near the 
dairy, and what was its nature and extent? 
(d) Have any cases of contagious or infectious disease 
occurred among the men since the last report? 
(€) Disposition of such cases. 
(f) What individual sickness has Secured among the men 
since the last report? 
(g) Disposition of such cases. 
(hk) Number of employees now quaeaibeved for sickness. 
(2) ‘Deseeibe the personal hygiene of the men employed for 
milking when prepared for and during the process of milking. 
(j) What facilities are provided for sickness in employees? 
(k) General hygienic condition of the dormitories or houses 
of the employees. 
(2) Suggestions for ac umowenicailt 
(m) What is the hygienic condition of the employees and 
their surroundings? 
(~) How many employees were examined at each of the 
foregoing visits? 
(0) Remarks. 
, 
Attending Physician. 
Date, 
