Part 1. Obligatory.

(i.) Has the child any mental symptoms other than mental deficiency? Signs of alcoholism, etc.?

(ii.) Is there reason to think the child has any weakness, congenital or acquired? Cretinism?

(iii.) Are there any (_a_) Sensory defects--sight? hearing? (_b_) Motor defects--paralysis? tremor, etc.?

(iv.) Is the child epileptic? What symptoms are present--convulsions, vertigo, loss of consciousness? Their frequency, etc.?

(v.) Has the child adenoids?

(vi.) Is the child hysterical?

(vii.) Any other ailments?

(viii.) What directions are to be given to the schoolmaster?