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Form 1045 Rev. Nov. 1941 AMERICAN RED CROSS NURSING SERVICE Name in full Tittman Anna Liouise office : State 8883 Home: wabash Tel. No. 8450 (last) (first) (middle) If married, give maiden name Not married Year of birth 1884 Marital status Husband's name (single, married, widowed, divorced) Permanent address Steveus Hotel Chicago Cook delinais (street) (city) (county) (state) Probable address 11 vl for the next year .. (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: Mrs. Robt. J. Travis Niece 3124 W. 114 Th St. Chicago (name) (relationship) (address) Ills. 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 Industrial Private duty Other (write in) Executive Director nurse Placement Sevinee. 8 So. nuclugan ave. Chicago 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) How many years did you attend HIGH SCHOOL? One Two Three Four Graduated Yes No SINCE GRADUATION FROM YOUR SCHOOL OF NURSING Had 3 hospital P. G. Courses have you ever had- 1. A postgraduate course or experience in any of the following special services? mostly Postgraduate course Experience in hospital in a hospital or public health field (at least 3 months) (at least 6 months) Communicable disease nursing (include Tbc) Psychiatric Nursing Operating room Anaesthesia Public health nursing 2. Have you taken any courses in a college or university Less than One Two Three Four Bachelor's Master's P.H.D. Certificate in *one year year years years years degree degree degree Public Health course Columbia university In what major field was above study? Organization and Supervision in Public nursing Health What languages, other than English, do you speak? Academic year (OVER) C

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Document identity
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    "ocrText": "Form 1045\nRev. Nov. 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nName\nin full Tittman Anna Liouise\noffice : State 8883\nHome: wabash\nTel. No.\n8450\n(last)\n(first)\n(middle)\nIf married, give maiden name Not married\nYear of birth 1884\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address Steveus Hotel Chicago Cook delinais\n(street)\n(city)\n(county)\n(state)\nProbable address\n11\nvl\nfor the next year\n..\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nMrs. Robt. J. Travis\nNiece\n3124 W. 114 Th St. Chicago\n(name)\n(relationship)\n(address)\nIlls.\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\nExecutive Director nurse Placement Sevinee.\n8 So. nuclugan ave. Chicago\nGovernment Service: Army, 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)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nYes\nNo\nSINCE GRADUATION FROM YOUR SCHOOL OF NURSING\nHad 3 hospital P. G. Courses\nhave you ever had-\n1. A postgraduate course or experience in any of the following special services?\nmostly\nPostgraduate course\nExperience in hospital\nin a hospital\nor public health field\n(at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include Tbc)\nPsychiatric Nursing\nOperating room\nAnaesthesia\nPublic health nursing\n2. Have you taken any courses in a college or university\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\n*one year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\nPublic Health\ncourse\nColumbia\nuniversity\nIn what major field was above study? Organization and Supervision in Public nursing Health\nWhat languages, other than English, do you speak?\nAcademic year\n(OVER)\nC"
}