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DMR1 THE AMERICAN RED CROSS DEPARTMENT OF NURSING Application for Enrollment (To be filled out entirely in applicant's handwriting and each question answered fully) 2. Address in full Street 4, n. Preston of City Phila 1. Name of applicant in full I whis Sunder . State Penna 3. Date of birth Dec. 11th 1874 Place of birth Phila. Penna 4. Are you married, single or a widow? Single Are you a citizen of the no United States? Yes 5. Have you any physical defects or tendency to constitutional or pulmonary trouble? Are you physically strong and healthy? yes 6. Name educational institutions attended before entering training school, stating number of years at each and from which you were graduated Phila. Public schools. Rights Trade. 7. 8. Occupation before entering training school Henographer Editorial dept Saturday Evening Post. What languages other than English do you speak? none- but have beging Frends lessons 9. City and state Phila Pa. From what hospital training school did you receive your diploma? bhildrens Homeopathic Phila- Date of graduation June 1906 10. Character of hospital: General? general Special bhildrens Put Private? 11. Did your training include obstetrics yes Care of men? yes. Children 120 eyes Contagious diseases? no 12. Daily average number of patients in hospital during training Length of course 2yes. 3 mo. 13. Name and address of superintendent of training school under whom you received training thing Kashami Johnsom - Home for Incurates. 48 Moodland are Phila Pa Orst traduck 14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each bouse if 6 moom allegheny General Hosp Pitsfurg Pa. Public Health nurses. also. Phila-Pa- 15. Of what nursing organizations are you a member? alumili bhild. Hobreoposhis. Hrsf. Both - 16. Which, if any, is affiliated with the American Nurses Association? I think 17. Give name and address of secretary of at least one of these organizations mrs. L. Roinstock br. 3124 t sto. Phila- Alumni bhildrens Homeo-Hosp. 18. Are you a registered nurse? yes In what state Penna Date of registration 1/8/1910 Number - 594 19. How and where employed since graduation : Give dates with months. Name and address of employers Some prink hursing 4906-1907-1908- Hahneman Hosp. Head hurse this Era. food Halmeman Hosp muses. Support Juny way Hosp. Springtake n.f. In June ackemam g. Yess Phila. Ser Homes Hop Supt I.H.M. Gay -1687 4.54 1st Phila Ghila Publis Schyol hurse Sept 1913-be 1917Miss Kashaine Johnson 15th Mila Presty Hrap Social Service childrens lept - Dec. 1916- still there 11/29/18- Miss Francis Hosketter Thesty ss. Phila (Specify for which of the following services you wish to be considered.) 20. War service, wherever needed When available September 16th 1918. Are you willing to take the oath of allegiance? Instructor, Elementary build. Hygiene Melfare. inflance . Yes 21. 22. Public Health Nursing In Town and Country Nursing Service or for War Service 23. Name and permanent address of nearest relative bousing Mrs. Percival Straus 6012 norm St-Germanton Phila. Date im Jones 291 1918 Signature of Nurse Julies Singder To the Committee. This blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, 11, 29, and A. R. C. 703. Application forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval and endorsement by Local Committee, with credentials (Forms 3 and 4), together with Forms 10, 11 and 29, should be for- warded to the Chairman, Department of Nursing, American Red Cross, Washington, D. C. In case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the Local Committee, instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the Local Committee. from whence credentials will be procured. 1M I-May

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    "ocrText": "DMR1\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nApplication for Enrollment\n(To be filled out entirely in applicant's handwriting and each question answered fully)\n2. Address in full Street 4, n. Preston of City Phila\n1. Name of applicant in full I whis Sunder .\nState Penna\n3. Date of birth Dec. 11th 1874\nPlace of birth Phila. Penna\n4. Are you married, single or a widow? Single\nAre you a citizen of the no United States? Yes\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble?\nAre you physically strong and healthy?\nyes\n6. Name educational institutions attended before entering training school, stating number of years at each and from\nwhich you were graduated Phila. Public schools. Rights Trade.\n7.\n8. Occupation before entering training school Henographer Editorial dept Saturday Evening Post.\nWhat languages other than English do you speak? none- but have beging Frends lessons\n9.\nCity and state Phila Pa.\nFrom what hospital training school did you receive your diploma? bhildrens Homeopathic Phila-\nDate of graduation June 1906\n10.\nCharacter of hospital: General? general Special bhildrens\nPut\nPrivate?\n11. Did your training include obstetrics yes\nCare\nof\nmen?\nyes.\nChildren\n120\neyes\nContagious\ndiseases?\nno\n12. Daily average number of patients in hospital during training\nLength of course 2yes. 3 mo.\n13. Name and address of superintendent of training school under whom you received training thing\nKashami\nJohnsom - Home for Incurates. 48 Moodland are Phila Pa Orst traduck\n14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each\nbouse if 6 moom allegheny General Hosp Pitsfurg Pa.\nPublic Health nurses. also. Phila-Pa-\n15. Of what nursing organizations are you a member? alumili bhild. Hobreoposhis. Hrsf.\nBoth\n-\n16. Which, if any, is affiliated with the American Nurses Association?\nI think\n17. Give name and address of secretary of at least one of these organizations mrs. L. Roinstock\nbr. 3124 t sto. Phila- Alumni bhildrens Homeo-Hosp.\n18. Are you a registered nurse? yes In what state Penna Date of registration 1/8/1910 Number - 594\n19. How and where employed since graduation :\nGive dates with months.\nName and address of employers\nSome prink hursing\n4906-1907-1908-\nHahneman Hosp. Head hurse\nthis Era. food Halmeman Hosp\nmuses. Support Juny way Hosp. Springtake n.f.\nIn June ackemam g.\nYess Phila. Ser Homes Hop Supt\nI.H.M. Gay -1687 4.54 1st Phila\nGhila Publis Schyol hurse\nSept 1913-be 1917Miss Kashaine Johnson 15th Mila\nPresty Hrap Social Service\nchildrens lept -\nDec. 1916- still there 11/29/18- Miss Francis Hosketter Thesty ss. Phila\n(Specify for which of the following services you wish to be considered.)\n20. War service, wherever needed\nWhen available September 16th 1918.\nAre you willing to take the oath of allegiance?\nInstructor, Elementary build. Hygiene Melfare. inflance .\nYes\n21.\n22. Public Health Nursing\nIn Town and Country Nursing Service\nor for War Service\n23.\nName and permanent address of nearest relative bousing Mrs. Percival Straus\n6012 norm St-Germanton Phila.\nDate im Jones 291 1918\nSignature of Nurse Julies Singder\nTo the Committee.\nThis blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, 11, 29, and A. R. C.\n703. Application forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval\nand endorsement by Local Committee, with credentials (Forms 3 and 4), together with Forms 10, 11 and 29, should be\nfor-\nwarded to the Chairman, Department of Nursing, American Red Cross, Washington, D. C.\nIn case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the\nLocal Committee, instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the\nLocal Committee. from whence credentials will be procured.\n1M I-May"
}