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Form 1045 Rev. Nov. 1941 AMERICAN RED CROSS NURSING SERVICE Name in full Sara (last) m Gray Tel. No. Gr 7.4536 (first) (middle) If married, give maiden name Year of birth 1886 Marital status Husband's name (single, married, widowed, divorced) Permanent address % mrs m Snedden 2256202 St- City (street) (city) (county) (state) Probable for the next address year 63265St NY (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: her m (name) warmright. (relationship) Sister. Bengham Hall (address) Hrg. Canandaigna my Are you employed in nursing at the present time? Yes No PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Virginnia Day nursed 632 E 5 st. ng.ct Public health Industrial Private duty Other (write in) Social service 18yrs 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 in of the following special services? no.p.g postgraduate course or experience any Postgraduate course Experience in hospital in a hospital or public health field (at least 3 months) (at least 6 months) Communicable disease nursing (include Tbc) Psychiatric Nursing Operating room Experience 4yr Anaesthesia 6 miths Public health nursing writing hurning 2. Have you taken any courses in a college or university? no Less than One Two Three Four Bachelor's Master's P.H.D. *one year year years years years degree degree A Certificate in degree Public Health In what major field was above study? Tom none infect I What languages, other than English, do you speak? Academic year (OVER) 5-18-43 K,C,

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2661552
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    "ocrText": "Form 1045\nRev. Nov. 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nName in full Sara (last) m Gray\nTel. No. Gr 7.4536\n(first)\n(middle)\nIf married, give maiden name\nYear of birth 1886\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address % mrs m Snedden 2256202 St- City\n(street)\n(city)\n(county)\n(state)\nProbable for the next address year 63265St NY\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nher m (name) warmright. (relationship) Sister. Bengham Hall (address) Hrg. Canandaigna my\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nVirginnia Day nursed 632 E 5 st. ng.ct\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\nSocial service 18yrs\nGovernment Service: Army, 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 in of the following special services? no.p.g\npostgraduate course or experience any\nPostgraduate course\nExperience in hospital\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 Experience\n4yr\nAnaesthesia\n6 miths\nPublic health nursing writing hurning\n2. Have you taken any courses in a college or university?\nno\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\n*one year\nyear\nyears\nyears\nyears\ndegree\ndegree\nA\nCertificate in\ndegree\nPublic Health\nIn what major field was above study?\nTom none infect\nI\nWhat languages, other than English, do you speak?\nAcademic year\n(OVER)\n5-18-43 K,C,"
}