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2nd take R Form 1045 Rev. Nov. 1942 AMERICAN RED CROSS 81 TI NURSING SERVICE Washville Davidean - to If you have changed your last name since contacting us, please check here Name in full Laxton M. Ruth Tel. No. 5-6311 (last) (first) (middle) If married, give maiden name Date of birth Nov, 7, 1902 Marital status Single Husband's name (single, married, widowed, divorced) Permanent address Moravian Falls Wilkes North Carolina (street) (city) (county) (state) Probable address General Hospital, Nashville Davidson Tennessee for the next year (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: Mrs. W. A. Laxton Mother Moravian .Falls, North Carolina (name) (relationship) (address) Are you employed in nursing at the present time? Yes No PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Public Health Instructor and student health councelor Public health Industrial Private duty Other (write in) 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) If not employed, what type of nursing would you prefer to render? How many years did you attend HIGH SCHOOL? One Two Three Four Graduated Yes No Before entering training, how many years did you attend COLLEGE? one Did you have a five-year course granting bachelor's degree? No but received bachelor's degree after AFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have- finishing training. Postgraduate course in a hospital Experience in hospital 1. A postgraduate course or experience in any of the following services? (at least 3 months) (at least 6 months) Communicable disease nursing (include tuberculosis) Psychiatric nursing Operating room Anaesthesia 2. Have you had any courses in a college or university? Less than One Two Three Four Bachelor's Master's Ph.D. M. D. I one academic year year years years years degree degree degree degree In what major field was above study? Public health nursing D. 3. Training and experience in the public health field: Postgraduate 4 months or more Certificate Degree Experience 6 months Ten years Have you ever held a position as an air hostess? Yes No How long? Have you ever had any other air experience? Yes No Specify (OVER)

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    "ocrText": "2nd take\nR\nForm 1045\nRev. Nov. 1942\nAMERICAN RED CROSS\n81 TI\nNURSING SERVICE\nWashville Davidean - to\nIf you have changed your last name since\ncontacting us, please check here\nName in full Laxton\nM.\nRuth\nTel. No. 5-6311\n(last)\n(first)\n(middle)\nIf married, give maiden name\nDate of birth Nov, 7, 1902\nMarital status\nSingle\nHusband's name\n(single, married, widowed, divorced)\nPermanent address\nMoravian Falls\nWilkes\nNorth Carolina\n(street)\n(city)\n(county)\n(state)\nProbable address\nGeneral Hospital, Nashville\nDavidson\nTennessee\nfor the next year\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nMrs. W. A. Laxton\nMother\nMoravian .Falls, North Carolina\n(name)\n(relationship)\n(address)\nAre you employed in nursing at the present time?\nYes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic Health Instructor and student health councelor\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\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)\nIf not employed, what type of nursing would you prefer to render?\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nFour\nGraduated\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE?\none\nDid you have a five-year course granting bachelor's degree? No but received bachelor's degree after\nAFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-\nfinishing training.\nPostgraduate course\nin a hospital\nExperience in hospital\n1. A postgraduate course or experience in any of the following services? (at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include tuberculosis)\nPsychiatric nursing\nOperating room\nAnaesthesia\n2. Have you had any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\nM. D.\nI\none academic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was above study?\nPublic\nhealth\nnursing\nD.\n3. Training and experience in the public health field: Postgraduate 4 months or more\nCertificate\nDegree\nExperience 6 months\nTen years\nHave you ever held a position as an air hostess?\nYes\nNo\nHow long?\nHave you ever had any other air experience?\nYes\nNo\nSpecify\n(OVER)"
}