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A 5 - S e D 5 + 0 5 FORM 843 SOUTHWESTERN Revised 1-15-21 DIVISION PUBLIC HEALTH NURSES SERVICE SLIP Dld Enrol lment Antoinette Ahlschier Name 409 Enrollment No. Appointed to Kaufman County Chapter Terrell, Texas (Name of service) Nurses office address c/o A.R.C. (City) (State) Course taken at (Length of course) Loan National Headquarters On paid from Funds Scholarship Chapter Assigned 9/13/21 Resigned 5/20/22 Transferred Reason for resignation To take further training. Dismissed (Dates) o.K. Desirability for future appointment A I - S + 0 a - C

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