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Form 1045
Rev. Nov. 1941
AMERICAN RED CROSS
NURSING SERVICE
Name in full
Hobein
Cora
FLossie
(last)
(first)
(middle)
Tel. No. Barring ton 204W
0
If married, give maiden name
Year of birth 1884
Marital status
Single
Husband's name
a
(single, married, widowed, divorced)
Permanent address 400 (s@eet) grove Ave. Barring ton (county) Coo
ILLinois
(state)
Probable address
F
for the next year 400 grove (street) Ave. B
Cook
ILLinoic
-
(county)
(state)
0
Give name and address of nearest relative or friend in United States:
Benj (name) H. Hobein
Brother
400 Barrington, ILL.
S
(relationship)
si
-
Are you employed in nursing at the present time? Yes
No
planning to teach R. C Home
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
bursing class in February
e
Institutional
Public health
Industrial
Private duty
Other (write in)
Busy in home and Local Community
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
Mother (specify)
How many years did you attend HIGH SCHOOL? One
Two
Three
Four
Graduated
Yes
No
SINCE GRADUATION FROM YOUR SCHOOL OF NURSING
Equivalent of High School
have you ever had-
1. A postgraduate course or experience in any of the following special services?
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
Anaesthesia
Public health nursing
2. Have you taken any courses in a college or university?
NOTICE Signature
SENT.
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
Registered public Health nurse in ILL.
In what major field was
above study? Public Health. Hospital Adminis tration
What languages, other than English, do you speak?
Chinese
german
120
CERT
*
Academic year
(OVER)
Page data
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- Source index
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- Type
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- Media ID
- 7d04f9f96e3597c9
- Size
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Document data
- ID
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- Core
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- Type
- document
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"ocrText": "I\nForm 1045\nRev. Nov. 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nName in full\nHobein\nCora\nFLossie\n(last)\n(first)\n(middle)\nTel. No. Barring ton 204W\n0\nIf married, give maiden name\nYear of birth 1884\nMarital status\nSingle\nHusband's name\na\n(single, married, widowed, divorced)\nPermanent address 400 (s@eet) grove Ave. Barring ton (county) Coo\nILLinois\n(state)\nProbable address\nF\nfor the next year 400 grove (street) Ave. B\nCook\nILLinoic\n-\n(county)\n(state)\n0\nGive name and address of nearest relative or friend in United States:\nBenj (name) H. Hobein\nBrother\n400 Barrington, ILL.\nS\n(relationship)\nsi\n-\nAre you employed in nursing at the present time? Yes\nNo\nplanning to teach R. C Home\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nbursing class in February\ne\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\nBusy in home and Local Community\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\nMother (specify)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nYes\nNo\nSINCE GRADUATION FROM YOUR SCHOOL OF NURSING\nEquivalent of High School\nhave you ever had-\n1. A postgraduate course or experience in any of the following special services?\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\nAnaesthesia\nPublic health nursing\n2. Have you taken any courses in a college or university?\nNOTICE Signature\nSENT.\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\nRegistered public Health nurse in ILL.\nIn what major field was\nabove study? Public Health. Hospital Adminis tration\nWhat languages, other than English, do you speak?\nChinese\ngerman\n120\nCERT\n*\nAcademic year\n(OVER)"
}