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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

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2662441
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Type
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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"
}