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and Form 1045 AMERICAN RED CROSS DC Rev. Nov. 1942 NURSING SERVICE 20 falk If you have changed your last name since Wabb BLANche contacting us, please check here. Name in full FRANKlIN Tel. No. 1466 (last) (first) (middle) If married, give maiden name Date of birth June 11,1885 Marital status sungle Husband's name (single, married, widowed, divorced) Permanent address. 115th Unguna Beach Prucess Cume Va (street) (city) (county) (state) Probable address for the next year 115"St (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: - IN WEbb Benter (name) (relationship) 1018 magurlia (address) Care Narfach VA 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) Retured after 25 yrs. m Public Health Nursm 9 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) componetic If not employed, what type of nursing would you prefer to render? Equianent How many years did you attend HIGH SCHOOL? One Two Three Mrs Heshandian Four Graduated Purate sclerres X Yes No Before entering training, how many years did you attend COLLEGE? Issuester T1 Receiver crush Did you have a five-year course granting bachelor's degree? No AFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have- Postgraduate course in a hospital Experience in hospital 1. A postgraduate course or experience in any of the following services? (at least 3 months) (at least 6 months) Communicable disease nursing (include tuberculosis) Psychiatric nursing Operating room Anaesthesia 2. Have you had any courses in a college or university? Less than One Two Three Four Bachelor's Master's Ph.D. M. D. one academic year year years years years degree degree degree degree In what major field was above study? Publec Health Nursurs 3. Training and experience in the public health field: Postgraduate 4 months or more Certificate Degree Experience 6 months Have you ever held a position as an air hostess? Yes No How long? Have you ever had any other air experience? Yes No Specify (OVER)

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    "ocrText": "and\nForm 1045\nAMERICAN RED CROSS\nDC\nRev. Nov. 1942\nNURSING SERVICE\n20 falk\nIf you have changed your last name since\nWabb BLANche\ncontacting us, please check here.\nName in full\nFRANKlIN\nTel. No. 1466\n(last)\n(first)\n(middle)\nIf married, give maiden name\nDate of birth June 11,1885\nMarital status\nsungle\nHusband's name\n(single, married, widowed, divorced)\nPermanent address. 115th\nUnguna Beach Prucess Cume\nVa\n(street)\n(city)\n(county)\n(state)\nProbable address\nfor the next year\n115\"St\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\n- IN WEbb\nBenter\n(name)\n(relationship)\n1018 magurlia (address) Care Narfach VA\nAre you employed in nursing at the present time?\nYes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\nRetured after 25 yrs. m Public Health Nursm 9\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES Administration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral staff\nOther (specify) componetic\nIf not employed, what type of nursing would you prefer to render?\nEquianent\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nMrs\nHeshandian\nFour\nGraduated\nPurate sclerres\nX\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE? Issuester T1 Receiver crush\nDid you have a five-year course granting bachelor's degree?\nNo\nAFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-\nPostgraduate course\nin a hospital\nExperience in hospital\n1. A postgraduate course or experience in any of the following services? (at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include tuberculosis)\nPsychiatric nursing\nOperating room\nAnaesthesia\n2. Have you had any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\nM. D.\none academic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was\nabove study? Publec Health Nursurs\n3. Training and experience in the public health field: Postgraduate 4 months or more\nCertificate\nDegree\nExperience 6 months\nHave you ever held a position as an air hostess?\nYes\nNo\nHow long?\nHave you ever had any other air experience?\nYes\nNo\nSpecify\n(OVER)"
}