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The precise origins of the dimensions of US letter-size paper (8.5 × 11 in) are not known. The American Forest & Paper Association says that the standard US dimensions have their origin in the days of manual papermaking, the 11-inch length of the standard paper being about a quarter of "the average maximum stretch of an experienced vatman's arms". [2]
A size chart illustrating the ANSI sizes. In 1992, the American National Standards Institute adopted ANSI/ASME Y14.1 Decimal Inch Drawing Sheet Size and Format, [1] which defined a regular series of paper sizes based upon the de facto standard 8 + 1 ⁄ 2 in × 11 in "letter" size to which it assigned the designation "ANSI A".
The former government size is still commonly used in spiral-bound notebooks, for children's writing and the like, a result of trimming from the current Letter dimensions. By extension of the American standards, the halved Letter size, 5 + 1 ⁄ 2 in × 8 + 1 ⁄ 2 in (140 mm × 215 mm
Note: 279.4 mm is the length of a 'Letter' sized paper. For A4 the length is 297 mm This media should work for many people with some kind of color (blindness) deficiency .
Hence, each next size is nearly exactly half the area of the prior size. So, an A1 page can fit two A2 pages inside the same area. The most used of this series is the size A4, which is 210 mm × 297 mm (8.27 in × 11.7 in) and thus almost exactly 1 ⁄ 16 square metre (0.0625 m 2 ; 96.8752 sq in) in area.
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The routine physical, also known as general medical examination, periodic health evaluation, annual physical, comprehensive medical exam, general health check, preventive health examination, medical check-up, or simply medical, is a physical examination performed on an asymptomatic patient for medical screening purposes.