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Form 1045
228
Rev. Nov. 1941
AMERICAN RED CROSS
NURSING SERVICE
je
Name in
full WAteRbliRy Rath ChRisTiano
Tel. No.
(last)
(first)
(middle)
Year of birth 1881.
If married, give maiden name
Marital status
Husband's name
Permanent address at present (city) (county) Alexandria La (state)
(single, married, widowed, divorced)
(street)
Ch
Probable address
same as above
for the next year
(street)
(city)
(county)
(state)
Giye name and address of nearest relative or friend in United States:
mrs (name)
Sister (relationship) 615 N meterough (address) St Johit, Allinois
Are you employed in nursing at the present time? Yes
No
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
n
Institutional
a
Public health
Industrial
/
Private duty
Other (write in)
US. army Exchange Camp supervisor clailond Clarborne La as
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
have you ever had-
1. A postgraduate course or experience in any of the following special services?
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
General Hospital
Anaesthesia
Public health nursing
2. Have you taken any courses in a college or university?
Less than
Two
Three
Four
Bachelor's
Master's
P.H.D.
Certificate in
One
years
degree
degree
Public Health
'one year
year
years
years
degree
the
In above Public Health
what major field was study?
What languages, other than English, do you speak? not any
(OVER)
* Academic year
Page data
- Page
- 11
- Source index
- 0
- Type
- photo
- Media ID
- 8c5f1ec40fa6f740
- Size
- unknown
Document data
- ID
- 2662441
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source metadata
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Document source extras
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Page context
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"ocrText": "Form 1045\n228\nRev. Nov. 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nje\nName in\nfull WAteRbliRy Rath ChRisTiano\nTel. No.\n(last)\n(first)\n(middle)\nYear of birth 1881.\nIf married, give maiden name\nMarital status\nHusband's name\nPermanent address at present (city) (county) Alexandria La (state)\n(single, married, widowed, divorced)\n(street)\nCh\nProbable address\nsame as above\nfor the next year\n(street)\n(city)\n(county)\n(state)\nGiye name and address of nearest relative or friend in United States:\nmrs (name)\nSister (relationship) 615 N meterough (address) St Johit, Allinois\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nn\nInstitutional\na\nPublic health\nIndustrial\n/\nPrivate duty\nOther (write in)\nUS. army Exchange Camp supervisor clailond Clarborne La as\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)\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nFour\nGraduated\nYes\nNo\nSINCE GRADUATION FROM YOUR SCHOOL OF NURSING\nhave you ever had-\n1. A postgraduate course or experience in any of the following special services?\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\nGeneral Hospital\nAnaesthesia\nPublic health nursing\n2. Have you taken any courses in a college or university?\nLess than\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\nOne\nyears\ndegree\ndegree\nPublic Health\n'one year\nyear\nyears\nyears\ndegree\nthe\nIn above Public Health\nwhat major field was study?\nWhat languages, other than English, do you speak? not any\n(OVER)\n* Academic year"
}