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1
AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
I. Name of applicant
alicia E linabeth Hibbard
2. Address
3. Date of birth Oct. 12-1871 Place of birth S one Canada
2.41 East 19th ster new york
4. Are you married, single or a widow? single
5. you yes
Are a citizen of the United States?
6.
Have you any physical defects? have chat 7 know of
7. Education and occupation before entering Training School High school
Seveness at have
8. From what Training School did you graduate Kings country Hed
Imaining School
9. hospital: General? ofes
Character of
Special?
Private?
IO. How many beds in hospital at time of graduation ? 6.00
II. Date of graduation g an 16-1881. Length of course 2% ys
I2.
Name and address of Superintendent of Training School under whom you were trained
Anios mantha O'meill. Pres add unbnown
I3. Of what nursing organization are you a member?
14. Give name and address of Secretary
I5. Are you a registered nurse? yes In what State? an yark
Date
of registration march 7-1910
16. How and where have you been employed since graduation? Give information for each year
Private musing Histrict nursing
17. Name and permanent address of nearest relative Omri % Hibland
Date fan 15-2/11
Signature althous 20 munuc 2. Hibland pl. Breadlyn
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"ocrText": "I\nb\na\n1\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nI. Name of applicant\nalicia E linabeth Hibbard\n2. Address\n3. Date of birth Oct. 12-1871 Place of birth S one Canada\n2.41 East 19th ster new york\n4. Are you married, single or a widow? single\n5. you yes\nAre a citizen of the United States?\n6.\nHave you any physical defects? have chat 7 know of\n7. Education and occupation before entering Training School High school\nSeveness at have\n8. From what Training School did you graduate Kings country Hed\nImaining School\n9. hospital: General? ofes\nCharacter of\nSpecial?\nPrivate?\nIO. How many beds in hospital at time of graduation ? 6.00\nII. Date of graduation g an 16-1881. Length of course 2% ys\nI2.\nName and address of Superintendent of Training School under whom you were trained\nAnios mantha O'meill. Pres add unbnown\nI3. Of what nursing organization are you a member?\n14. Give name and address of Secretary\nI5. Are you a registered nurse? yes In what State? an yark\nDate\nof registration march 7-1910\n16. How and where have you been employed since graduation? Give information for each year\nPrivate musing Histrict nursing\n17. Name and permanent address of nearest relative Omri % Hibland\nDate fan 15-2/11\nSignature althous 20 munuc 2. Hibland pl. Breadlyn"
}