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I
2nd
Form 1045
OMA
AHT
3V1
are
Rev. Nov. 1942
AMERICAN RED CROSS
xoa
NURSING SERVICE
Reussilear Ca
D
Whs.
If you have changed your last name since
contacting us, please check here
Name in full
(last) Coloirs any (first)
beay
Tel. No. Thoy 2696J-
in
M
1
(middle)
If married, give maiden name
ancy way Hilliard
Date of birth 1872
S
Marital status
Cordow
Husband's name
Heury Calvies
D
(single, married, widowed, divorced)
Permanent address
(street) 42 Record street (city) tray (county) - Reues. (state) u.4.
5
Probable address
same
.vabdhid
I
)
for the next year
(street)
(city)
(county)
(state)
It
vhoorle
100
Give name and address of nearest relative or friend in United States:
Turs. devey (name) Hellow (relationship) worker (929rn-old) - (address) 5, Kenmore are. hewarle of if
Are you employed in nursing at the present time?
Yes
No
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
Institutional
Public health
Retered
I
Industrial
bloow
Private duty
5
Other (write in)
Government Service:
Army, Regular
Navy, Regular
Veterans Administration
Reserve
Reserve
Children's Bureau
U.S.P.H. Service
U.S. Indian Service
MAJOR RESPONSIBILITIES Administration
Teaching
Private duty
of present employment
Supervision
General staff
Other (specify)
If employed, what type of nursing would you prefer to render? (Dammuntrative Emergency
not
How many years did you attend HIGH SCHOOL?
One
Two
Three
Four
Graduated
Yes
No
Before entering training, how many years did you attend COLLEGE?
Did you have a five-year course granting bachelor's degree?
AFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-
Postgraduate course
in a hospital
Experience in hospital
1. A postgraduate course or experience in any of the following services? (at least 3 months)
(at least 6 months)
Communicable disease nursing (include tuberculosis)
Psychiatric nursing
Operating room
all
Anaesthesia
2. Have you had any courses in a college or university?
Less than
One
Two
Three
Four
Bachelor's
Master's
Ph.D.
M. D.
one academic year
year
years
years
years
degree
degree
degree
degree
In what major field was above study?
3. Training and experience in the public health field: Postgraduate 4 months or more
Certificate
Degree
Experience 6 months
Have you ever held a position as an air hostess?
Yes
No
How long?
Have you ever had any other air experience?
Yes
No
Specify
(OVER)
Page data
- Page
- 13
- Source index
- 0
- Type
- photo
- Media ID
- a26467058f0a3254
- Size
- unknown
Document data
- ID
- 2661263
- Core
- doc
- Type
- document
DTO data
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Document source extras
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"ocrText": "I\n2nd\nForm 1045\nOMA\nAHT\n3V1\nare\nRev. Nov. 1942\nAMERICAN RED CROSS\nxoa\nNURSING SERVICE\nReussilear Ca\nD\nWhs.\nIf you have changed your last name since\ncontacting us, please check here\nName in full\n(last) Coloirs any (first)\nbeay\nTel. No. Thoy 2696J-\nin\nM\n1\n(middle)\nIf married, give maiden name\nancy way Hilliard\nDate of birth 1872\nS\nMarital status\nCordow\nHusband's name\nHeury Calvies\nD\n(single, married, widowed, divorced)\nPermanent address\n(street) 42 Record street (city) tray (county) - Reues. (state) u.4.\n5\nProbable address\nsame\n.vabdhid\nI\n)\nfor the next year\n(street)\n(city)\n(county)\n(state)\nIt\nvhoorle\n100\nGive name and address of nearest relative or friend in United States:\nTurs. devey (name) Hellow (relationship) worker (929rn-old) - (address) 5, Kenmore are. hewarle of if\nAre you employed in nursing at the present time?\nYes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nRetered\nI\nIndustrial\nbloow\nPrivate duty\n5\nOther (write in)\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES Administration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral staff\nOther (specify)\nIf employed, what type of nursing would you prefer to render? (Dammuntrative Emergency\nnot\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nFour\nGraduated\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE?\nDid you have a five-year course granting bachelor's degree?\nAFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-\nPostgraduate course\nin a hospital\nExperience in hospital\n1. A postgraduate course or experience in any of the following services? (at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include tuberculosis)\nPsychiatric nursing\nOperating room\nall\nAnaesthesia\n2. Have you had any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\nM. D.\none academic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was above study?\n3. Training and experience in the public health field: Postgraduate 4 months or more\nCertificate\nDegree\nExperience 6 months\nHave you ever held a position as an air hostess?\nYes\nNo\nHow long?\nHave you ever had any other air experience?\nYes\nNo\nSpecify\n(OVER)"
}