When Visas were established in the U.S. starting in the early 1920s, many of the screening exams at the U.S. Immigration ports such as Ellis Island were taken over by the U.S. Consulates abroad. The immigrant(s) may have filled out a "Declaration of Alien About To Depart For The United States". They may have had to show an "Affidavit In Support Of Application For Visa" filled out by some person in the United States that was notarized that they swore they could maintain the person once they arrived in the U.S. The consulate was also responsible for giving a literacy test to the potential immigrant that they had to pass unless they were going to a close relative (mother, father, etc.) already in U.S. After the 1924 quotas, the number of immigrants allowed entry from southern and eastern Europe were drastically reduced. The consulate was also responsible for the medical exam. I'm not sure how extensive that was. I have in my files as part of the visa documents and passport of one immigrant the result of a physical exam. I'm attaching it to my post as it's the only one I've ever seen. As you will see, the concern was with infectious diseases, not physical ailments. But that's only a sample of one. So there were a number of hurdles for immigrants to get Visas. The U.S. did not welcome immigrants with open arms during this period of time from certain areas of the world.
Dana Point, CA