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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)
Page data
- Page
- 32
- Source index
- 0
- Type
- photo
- Media ID
- 40daf1e51f24be5a
- Size
- unknown
Document data
- ID
- 2661809
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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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)"
}