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Form 1045
Rev. Nov. 1941
AMERICAN RED CROSS
NURSING SERVICE
Name in full Dietrich, Miss Anna
Louise
Tel. No M. 6080
D
(last)
(first)
(middle)
-
If married, give maiden name
Year of birth 1878
Marital status
Husband's name
(single, married, widowed, divorced)
0
Permanent address
1001 E. Nevada St
--Paso
Texas
S
(street)
(city)
(county)
(state)
Probable address
for the next year
Since this has been my address for over 30 years, it will be permanent
s
(street)
(city)
(county)
(state)
Give name and address of nearest relative or friend in United States:
Miss Emily Dana Greene R.N. 445 Monterey Blvd. Hermosa Beach
Cal.
(name)
(relationship)
(address)
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
Industrial
Private duty
Am also Special Agent U.S.P.H.S. without
Other (write in)
General Secretary Texas G.N.A. ; compensation, but plenty of work.
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)
How many years did you attend HIGH SCHOOL? One
Two
Three
Four
Graduated
Yes
No
SINCE GRADUATION FROM YOUR SCHOOL OF NURSING
have you ever had-
1. A postgraduate course or experience in any of the following special services?
Postgraduate course
Yes
Experience in hospital
Yes
in a hospital
or public health field
(at least 3 months)
(at least 6 months)
Communicable disease nursing (include Tbc)
Psychiatric Nursing
Operating room
Anaesthesia
2 years Ex.
Public health nursing
2. Have you taken any courses in a college or university?
Less than
One
Two
Three
Four
Bachelor's
Master's
P.H.D.
Certificate in
'one year
year
years
years
years
degree
degree
degree
Public Health
2 courses
Columbia
Greeley
Corrospondence courses in University of Texas
e
2.
In what major field was above study?
Public Health
What languages, other than English, do you speak?
None
for
Academic year
(OVER)
Page data
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- Source index
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- Type
- photo
- Media ID
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- Size
- unknown
Document data
- ID
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- Core
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- Type
- document
DTO data
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"ocrText": "e\n+\nForm 1045\nRev. Nov. 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nName in full Dietrich, Miss Anna\nLouise\nTel. No M. 6080\nD\n(last)\n(first)\n(middle)\n-\nIf married, give maiden name\nYear of birth 1878\nMarital status\nHusband's name\n(single, married, widowed, divorced)\n0\nPermanent address\n1001 E. Nevada St\n--Paso\nTexas\nS\n(street)\n(city)\n(county)\n(state)\nProbable address\nfor the next year\nSince this has been my address for over 30 years, it will be permanent\ns\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nMiss Emily Dana Greene R.N. 445 Monterey Blvd. Hermosa Beach\nCal.\n(name)\n(relationship)\n(address)\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nAm also Special Agent U.S.P.H.S. without\nOther (write in)\nGeneral Secretary Texas G.N.A. ; compensation, but plenty of work.\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES\nAdministration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral Staff\nOther (specify)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nYes\nNo\nSINCE GRADUATION FROM YOUR SCHOOL OF NURSING\nhave you ever had-\n1. A postgraduate course or experience in any of the following special services?\nPostgraduate course\nYes\nExperience in hospital\nYes\nin a hospital\nor public health field\n(at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include Tbc)\nPsychiatric Nursing\nOperating room\nAnaesthesia\n2 years Ex.\nPublic health nursing\n2. Have you taken any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\n'one year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\nPublic Health\n2 courses\nColumbia\nGreeley\nCorrospondence courses in University of Texas\ne\n2.\nIn what major field was above study?\nPublic Health\nWhat languages, other than English, do you speak?\nNone\nfor\nAcademic year\n(OVER)"
}