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N
A
grd
MI
Form 1045
Rev. Nov. 1942
CEMA worsa AMERICAN RED CROSS
P
zos
NURSING SERVICE
Seattle-king co,
If you have changed your last name since
Name in full Auer, Ursula Tibbels
contacting us, please check here
Tel. No. Kenwood 5333
C
(last)
(first)
(middle)
If married, give maiden name Tibbels
Date of birth April 23, 1883.
Marital status
married
Husband's name Carl L. Auer
Permanent address 3113 E 65th ) Seattle King
(single, married, widowed, divorced)
Washington.
(street)
(city)
(county)
(state)
Probable address
for the next year
same
(street)
(city)
(county)
(state)
vhania Jon
Give name and address of nearest relative or friend in United States:
Carl I Auer
husband 3113 E. 65th Seattle, Kash
(name)
(relationship)
(address)
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
American Red Cross Children's Clinic
Industrial
Private duty
Other (write in)
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)
If not employed, what type of nursing would you prefer to render?
How many years did you attend HIGH SCHOOL?
One
Two
Three
Four
Graduated
Yes
No
Before entering training, how many years did you attend COLLEGE?
3
Did you have a five-year course granting bachelor's degree?
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? Public Health nursing of Social
5
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)
Page data
- Page
- 22
- Source index
- 0
- Type
- photo
- Media ID
- e871d446d81fb3bb
- Size
- unknown
Document data
- ID
- 2661059
- Core
- doc
- Type
- document
DTO data
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"ocrText": "N\nA\ngrd\nMI\nForm 1045\nRev. Nov. 1942\nCEMA worsa AMERICAN RED CROSS\nP\nzos\nNURSING SERVICE\nSeattle-king co,\nIf you have changed your last name since\nName in full Auer, Ursula Tibbels\ncontacting us, please check here\nTel. No. Kenwood 5333\nC\n(last)\n(first)\n(middle)\nIf married, give maiden name Tibbels\nDate of birth April 23, 1883.\nMarital status\nmarried\nHusband's name Carl L. Auer\nPermanent address 3113 E 65th ) Seattle King\n(single, married, widowed, divorced)\nWashington.\n(street)\n(city)\n(county)\n(state)\nProbable address\nfor the next year\nsame\n(street)\n(city)\n(county)\n(state)\nvhania Jon\nGive name and address of nearest relative or friend in United States:\nCarl I Auer\nhusband 3113 E. 65th Seattle, Kash\n(name)\n(relationship)\n(address)\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\nAmerican Red Cross Children's Clinic\nIndustrial\nPrivate duty\nOther (write in)\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)\nIf not employed, what type of nursing would you prefer to render?\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nFour\nGraduated\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE?\n3\nDid you have a five-year course granting bachelor's degree?\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 degree\nIn\nwhat major field was above study? Public Health nursing of Social\n5\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)"
}