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ARMY
NURSE CORPS APR 2 0 1943
Application for Appointment
1. Name Stone Edith Virginia
(Last name)
(First name') (Midd}e name)
(Maiden name)
2.
Permanent address 5508 Queensbury Rd- Richmond, Ja.
(Street)
(City)
(County)
(State)
3. Probable address for one year Eastern Area- American Red cross, Alexandria,
(Street)
(City)
(County)
(State)
Ja,
4. Name and permanent address of nearest relative or friend residing in the United States:
Relationship mother
Mrs. B.T. stone. 5508-Queensbury Rd.
(Name)
(Address) Richmond. Jai
5.
Race
Nationality
Marital status
What languages other than
U.S. Citizenship
English do you speak?
White
Amer
Single
Widowed
Native born
Specify:
Negro
Married
Separated
Naturalized
Spanish
Other
Divorced
Non-Citizen
6. If divorced, attach copy of documentary evidence.
7. If naturalized citizen, give date, number, and place of naturalization rtificate
8.
If not a citizen of the United States, of what country are you a citizen?
9. Date of birth
5-10-13
10. Place of birth Richmond-U
(Month)
(Day)
(Year)
11. Is father a citizen of the U.S.A.? Yes
No
12. Country of birth of father u.s.
13. If married, give husband's full name
14. Permanent address of husband
15. Is your husband a member of the armed forces? Yes
No
If so, what branch of the service and
what grade does he hold in that branch?
List names of minor children, giving age of each:
16. Has adequate care been provided for minor children for the duration of the war plus six months
thereafter?
17. What is your height in inches? 64
18. Your weight in pounds? 128
19. Have you had any of the following? If so, state when and degree of incapacity.
Disease of the nasal sinuses
Tuberculosis ofkidney nephrectomy
Nervous break down
Menstrual disturbance
20. Major operations or serious injury: (Specify) rephrectomy. 1937
(A complete physical examination will be given before assignment.)
21. Have you given up any pursuit on account of ill health? If so, state particulars. no
22. In what state or states are you registered? Virginia
Year 1943
23. Number of Registration Certificate 7453 24. Are you registered for the current year? Yes
No
25.
Of what nursing organizations are you a member? American Red cross. A.n.A.
26. Have you ever been arrested for other than minor traffic violations? If so, state particulars.
no
27. Have you ever been served with a subpoena? Yes
No
2436485
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- Core
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"ocrText": "ARMY\nNURSE CORPS APR 2 0 1943\nApplication for Appointment\n1. Name Stone Edith Virginia\n(Last name)\n(First name') (Midd}e name)\n(Maiden name)\n2.\nPermanent address 5508 Queensbury Rd- Richmond, Ja.\n(Street)\n(City)\n(County)\n(State)\n3. Probable address for one year Eastern Area- American Red cross, Alexandria,\n(Street)\n(City)\n(County)\n(State)\nJa,\n4. Name and permanent address of nearest relative or friend residing in the United States:\nRelationship mother\nMrs. B.T. stone. 5508-Queensbury Rd.\n(Name)\n(Address) Richmond. Jai\n5.\nRace\nNationality\nMarital status\nWhat languages other than\nU.S. Citizenship\nEnglish do you speak?\nWhite\nAmer\nSingle\nWidowed\nNative born\nSpecify:\nNegro\nMarried\nSeparated\nNaturalized\nSpanish\nOther\nDivorced\nNon-Citizen\n6. If divorced, attach copy of documentary evidence.\n7. If naturalized citizen, give date, number, and place of naturalization rtificate\n8.\nIf not a citizen of the United States, of what country are you a citizen?\n9. Date of birth\n5-10-13\n10. Place of birth Richmond-U\n(Month)\n(Day)\n(Year)\n11. Is father a citizen of the U.S.A.? Yes\nNo\n12. Country of birth of father u.s.\n13. If married, give husband's full name\n14. Permanent address of husband\n15. Is your husband a member of the armed forces? Yes\nNo\nIf so, what branch of the service and\nwhat grade does he hold in that branch?\nList names of minor children, giving age of each:\n16. Has adequate care been provided for minor children for the duration of the war plus six months\nthereafter?\n17. What is your height in inches? 64\n18. Your weight in pounds? 128\n19. Have you had any of the following? If so, state when and degree of incapacity.\nDisease of the nasal sinuses\nTuberculosis ofkidney nephrectomy\nNervous break down\nMenstrual disturbance\n20. Major operations or serious injury: (Specify) rephrectomy. 1937\n(A complete physical examination will be given before assignment.)\n21. Have you given up any pursuit on account of ill health? If so, state particulars. no\n22. In what state or states are you registered? Virginia\nYear 1943\n23. Number of Registration Certificate 7453 24. Are you registered for the current year? Yes\nNo\n25.\nOf what nursing organizations are you a member? American Red cross. A.n.A.\n26. Have you ever been arrested for other than minor traffic violations? If so, state particulars.\nno\n27. Have you ever been served with a subpoena? Yes\nNo\n2436485"
}