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ORIGINAL Form No. 200 Revised 5-15-18 16W ni aniauoo nada boold vd lla to ada 21 ballonns doidw ni to AMERICAN RED CROSS mi to vns TO SERVICE APPLICATION FORM Applicants for Nursing and Medical Service must accompany this form with special forms supplied by the Nursing Service and the Medical Service Bureaus of the American Red Cross. I ni TEW oil steqioi These questions must be answered fully or the application will not be acted upon. G BOY 91A (D) di Date January 5th 1920 97638 07/11/2005 immol I. Name in full Helen Dore Boylstone Telephone No. 2. Permanent Address 39 Pleasant st Portemouth nit (Number and Street) (City) (State) 3. Temporary Address, if any, to what date untel Feb. 4,1920 . 99Commonweatth are Bostou mass. (Number and Street) (City) (State) 4. (a) any I, these in full with 2913-1917- France. 1917-1919 (Harvard unit) 99 com. are Boston If changes of residence since August 1914, give dates. mass. gin Hasp-Boston (b) What is your present business or profession? Trained nurse 1998-0-date Name of firm or corporation with which associated Dr. E. qranville brobtree Duration Business Address of Service. 99 year Commonwesth are Boston, Present Capacity in greating asst. (Number and Street) of (City) 5. Date of Birth 1894 (Year) april fer (Montb (a) Place of (State) n.H (8) (Day) (b) If of foreign birth, when and where did you arrive in the United States? ndW .OS 6. If foreign born, give date and court of your naturalization TUOV to 91632 7. (a) Single, married or widower. risonamA to (a) Number of Dependents (b) Full name of wife before marriage; or husband some c) Birthplace of wife or husband -Need Nationality of wife or husband (d) Birthplace and nationality of father of wife or husband - heristory with to back (6) ss nuoy rebiano2 uov ob nedW (d) (e) Birthplace and nationality of mother of wife or husband - January (f) (g) Birthplace and nationality of father. Duxbury, massachusetts-amrcal is Full name of father Joseph Boylston D.M.D. (b) rigistol 19100 DOY bluo W (h) If father foreign born, whether naturalized, when and where 9V198 uro bliroW (n) is bell as 9V193 of oldenu 71 (d) (i) Full maiden name of mother Fannic thright (j) Birthplace and nationality of mother Bangor, maire american grivil nol (k) If mother foreign born, whether naturalized, when and where 10 nonswollA 01 not wollA Innomi Plymouth mess (1) Full name and nationality of paternal grandfather Benjamin Boylstow americans (2) (m) doidw Dux burry americans Full maiden name and nationality of paternal grandmother Huldah efrages (n) Full name and nationality of maternal grandfather. Samuel wright Full maiden name and nationality of maternal grandmother. Elvira Dore England (o) W Bangar - american 8. (a) What previous business or professional experience have you had, stating nature, places and principal dates thereof; the names of the firms or corporations with which you were associated 1916 and 1917 I add 1917-/9/9-mtrance - with 1916- In charge Head penereal nurse- - mass. Clinics gen - mass. Harvard burgeal us gen. Happ bent. 8 9

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Context sent to Scholar

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    "ocrText": "ORIGINAL\nForm No. 200\nRevised 5-15-18\n16W\nni\naniauoo\nnada\nboold\nvd\nlla\nto\nada\n21\nballonns doidw ni to\nAMERICAN RED CROSS\nmi to vns TO\nSERVICE APPLICATION FORM\nApplicants for Nursing and Medical Service must accompany this form with special forms supplied by the Nursing Service and the Medical Service Bureaus\nof the American Red Cross.\nI\nni\nTEW\noil\nsteqioi These questions must be answered fully or the application will not be acted upon. G BOY 91A\n(D)\ndi\nDate January 5th 1920\n97638 07/11/2005 immol\nI. Name in full Helen Dore Boylstone\nTelephone No.\n2. Permanent Address 39 Pleasant st Portemouth\nnit\n(Number and Street)\n(City)\n(State)\n3. Temporary Address, if any, to what date untel Feb. 4,1920\n.\n99Commonweatth are Bostou mass.\n(Number and Street)\n(City)\n(State)\n4. (a) any I, these in full with\n2913-1917- France. 1917-1919 (Harvard unit) 99 com. are Boston\nIf changes of residence since August 1914, give dates. mass. gin Hasp-Boston\n(b)\nWhat is your present business or profession? Trained nurse 1998-0-date\nName of firm or corporation with which associated Dr. E. qranville brobtree\nDuration Business Address of Service. 99 year Commonwesth are Boston, Present Capacity in greating asst.\n(Number and Street) of (City)\n5. Date of Birth 1894 (Year) april fer (Montb (a) Place of (State) n.H\n(8)\n(Day)\n(b) If of foreign birth, when and where did you arrive in the United States?\nndW\n.OS\n6. If foreign born, give date and court of your naturalization\nTUOV to 91632\n7. (a) Single, married or widower. risonamA to (a) Number of Dependents\n(b) Full name of wife before marriage; or husband\nsome\nc) Birthplace of wife or husband\n-Need\nNationality of wife or husband\n(d) Birthplace and nationality of father of wife or husband - heristory with to back (6) ss\nnuoy rebiano2 uov ob nedW (d)\n(e) Birthplace and nationality of mother of wife or husband -\nJanuary\n(f)\n(g) Birthplace and nationality of father. Duxbury, massachusetts-amrcal is\nFull name of father Joseph Boylston D.M.D.\n(b)\nrigistol 19100 DOY bluo W\n(h) If father foreign born, whether naturalized, when and where\n9V198 uro bliroW (n) is\nbell\nas 9V193 of oldenu 71 (d)\n(i) Full maiden name of mother Fannic thright\n(j)\nBirthplace and nationality of mother Bangor, maire american grivil nol\n(k) If mother foreign born, whether naturalized, when and where\n10 nonswollA\n01 not wollA\nInnomi Plymouth mess\n(1) Full name and nationality of paternal grandfather Benjamin Boylstow\namericans\n(2)\n(m)\ndoidw Dux burry americans\nFull maiden name and nationality of paternal grandmother Huldah efrages\n(n) Full name and nationality of maternal grandfather. Samuel wright\nFull maiden name and nationality of maternal grandmother. Elvira Dore\nEngland\n(o)\nW\nBangar - american\n8.\n(a) What previous business or professional experience have you had, stating nature, places and principal dates\nthereof; the names of the firms or corporations with which you were associated 1916 and 1917\nI\nadd\n1917-/9/9-mtrance - with\n1916- In charge Head penereal nurse- - mass. Clinics gen - mass. Harvard burgeal us gen. Happ bent.\n8\n9"
}