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AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
now thing
1. Name of applicant
Mathild
2. Address
Harper Hospital mich
diseneger
3. Date of birth ang 21st 1869
Place
of
birth
neenah Wisconsin
4. Are you married, single d a widow?
5. Are a citizen of the United States ?
you no yes
6. Have you any physical defects?
7. Education and occupation before entering Training School Meenah High School
8.
From what training School did you graduate? illinois Training School
Chicago 1591 (Hospital Economics course 1904
9. Character of hospital: General?
Special?
Private
10. at
How many beds in hospital time of graduation? 1500
11. Date of graduation april - 1897
Length of course
two
12. Name and address of Superintendent of Training School under whom you were trained
Isalell melsaac Benton Hax Lor mich
13. Of what nursing organization are you a member? Supt Society, Michigan State
Wayne Country alumnae Illinois Training School
14.
Give
name
and address of Secretary. 924 Brysh Street
15. Are you a registered nurse? ue8
Delivert-mich
Date of registration 1910
In what State? michigata
16. How and where have you been employed since graduation? Give information for each year
12-year Presuyverian Has cericago
subgening Rush medical
La Crosse Lui-heran
17.
Name + and permanent address draining nearest relative School mrahF Fan'r and wise
Date mayo 1SL 1961
Signature Mathold H Krunger
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"ocrText": "+\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nnow thing\n1. Name of applicant\nMathild\n2. Address\nHarper Hospital mich\ndiseneger\n3. Date of birth ang 21st 1869\nPlace\nof\nbirth\nneenah Wisconsin\n4. Are you married, single d a widow?\n5. Are a citizen of the United States ?\nyou no yes\n6. Have you any physical defects?\n7. Education and occupation before entering Training School Meenah High School\n8.\nFrom what training School did you graduate? illinois Training School\nChicago 1591 (Hospital Economics course 1904\n9. Character of hospital: General?\nSpecial?\nPrivate\n10. at\nHow many beds in hospital time of graduation? 1500\n11. Date of graduation april - 1897\nLength of course\ntwo\n12. Name and address of Superintendent of Training School under whom you were trained\nIsalell melsaac Benton Hax Lor mich\n13. Of what nursing organization are you a member? Supt Society, Michigan State\nWayne Country alumnae Illinois Training School\n14.\nGive\nname\nand address of Secretary. 924 Brysh Street\n15. Are you a registered nurse? ue8\nDelivert-mich\nDate of registration 1910\nIn what State? michigata\n16. How and where have you been employed since graduation? Give information for each year\n12-year Presuyverian Has cericago\nsubgening Rush medical\nLa Crosse Lui-heran\n17.\nName + and permanent address draining nearest relative School mrahF Fan'r and wise\nDate mayo 1SL 1961\nSignature Mathold H Krunger"
}