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Form 1045
Rev. Nov. 1941
AMERICAN RED CROSS
NURSING SERVICE
2nd Re
Name If married, in full give Kaday maiden (last) name la dith (first) Arletha
Edith Patters
Tel. No Montrose 5539
(middle) Patter Year of birth 1897
Marital status. married
Husband's name John O. Hooly
D
Permanent address 5635 (single, (street) married, Riffeyts widowed, divorced) (city) Pitts Rey (county) (state) Pelina.
E
a
Probable address
for the next year
?
(street)
(city)
(county)
(state)
Mr. Give name (name) and address O. of Hody neares) (relationship) or Husfand States: 5635 (address) Riffey Pl., Pittohey! Pa:
relative friend in United
the
+
+
Are you employed in nursing at the present time? Yes
No
P
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
a C
Institutional
Public health
+
J.
Industrial
Private duty
en
Other (write in)
Falk Cluec
:
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
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?
Less than
One
Two
Three
Four
Bachelor's
Master's
P.H.D.
Certificate in
*one year
year
years
years
degree
degree
degree
Public Health
years
In none
what major field was above study?
What none
languages, other than English, do you speak?
(OVER)
*Academic year
I
&
Page data
- Page
- 83
- Source index
- 0
- Type
- photo
- Media ID
- c1806f45c594ee03
- Size
- unknown
Document data
- ID
- 2661661
- Core
- doc
- Type
- document
DTO data
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"ocrText": "I\nI\nForm 1045\nRev. Nov. 1941\nAMERICAN RED CROSS\nNURSING SERVICE\n2nd Re\nName If married, in full give Kaday maiden (last) name la dith (first) Arletha\nEdith Patters\nTel. No Montrose 5539\n(middle) Patter Year of birth 1897\nMarital status. married\nHusband's name John O. Hooly\nD\nPermanent address 5635 (single, (street) married, Riffeyts widowed, divorced) (city) Pitts Rey (county) (state) Pelina.\nE\na\nProbable address\nfor the next year\n?\n(street)\n(city)\n(county)\n(state)\nMr. Give name (name) and address O. of Hody neares) (relationship) or Husfand States: 5635 (address) Riffey Pl., Pittohey! Pa:\nrelative friend in United\nthe\n+\n+\nAre you employed in nursing at the present time? Yes\nNo\nP\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\na C\nInstitutional\nPublic health\n+\nJ.\nIndustrial\nPrivate duty\nen\nOther (write in)\nFalk Cluec\n:\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\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?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\n*one year\nyear\nyears\nyears\ndegree\ndegree\ndegree\nPublic Health\nyears\nIn none\nwhat major field was above study?\nWhat none\nlanguages, other than English, do you speak?\n(OVER)\n*Academic year\nI\n&"
}