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Mrs
Form 170
MEDICAL DEPARTMENT, U.S.A.
ARMY NURSE CORPS
(Authorized Feb. 15, 1943)
Application for Appointment
J.
1. Name Cartier,
June
arjeanne
DuShane
F
(Print or type all
(Last name)
(First name)
(Middle name)
(Maiden name)
on this line)
2.
Permanent address 308 Hungerford Ave,
Marquette
Michigan
(Street)
(City)
(County)
(State)
3. Probable address for one year 308 Hungerford Ave,
Marquette
Michigan
(Street)
(City)
(County)
(State)
4. Name and permanent address of nearest relative or friend residing in the United States:
Parents Mr. &c Mrs. Frank DuShane, 308 Hungerford Ave,
Relationship
(Name)
5.
Negaunee, (Address)
Race
Nationality
Marital status
U. S. citizenship
What languages other than English do you speak?
(Specify)
White
Single
Widowed
Native born
Finnish
Negro
Married
Separated
Naturalized
Other
Divorced
Noncitizen
6. If divorced, attach copy of documentary evidence.
7. If naturalized citizen, give date, number, and place of naturalization certificate
a
S
8. If not a citizen of the United States, of what country are you a citizen?
9. Date of birth August 31
1920
10. Place of birth
Ishpeming, Michigan
(Month)
(Year)
P
(Day)
11. Is father a citizen of the U. S. A.? Yes
No
12. Country of birth of father United States
S
13. If married, give husband's full name
Sergeant Albert Jean Cartier
14. Permanent address of husband
7 Rose Street, Haverhill, Mass.
e
15. Is your husband a member of the armed forces? Yes No
If so, what branch of the service and what grade does he
hold in that branch?
Sergeant- Post Headquarters, Personnel Section
List names of minor children, giving age of each:
16. Has adequate care been provided for minor children for the duration of the war plus 6 months thereafter?
17. What is your height in inches?
5 ft. 4 in.
18. Your weight in pounds? 175lbs.
19. Have you had any of the following? If so, state when and degree of incapacity.
Disease of the nasal sinuses
Nervous breakdown
Tuberculosis
Menstrual disturbance
None
20. Major operations or serious injury (specify)
None
(A complete physical examination will be given before assignment)
No
21. Have you given up any pursuit on account of ill health? If so, state particulars
22. In what State or States are you registered? Michigan - Territory of Hawaii Year
1942-,,1945
1963-Hawail
I
23. Number of Registration Certificate 30645
24. Are you registered for the current year? Yes
No
25. Of what nursing organizations are you a member? Alumnae, District, State, American ASsoiations Nursing
26. Have you ever been arrested for other than minor traffic violations? If so, state particulars
No
27. Have you ever been served with a subpena? Yes
No
16-33343-1
Page data
- Page
- 18
- Source index
- 0
- Type
- photo
- Media ID
- 022b84c363fc2d60
- Size
- unknown
Document data
- ID
- 2661222
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source extras
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"logicalDate": "1945-08-20",
"month": 8,
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Page context
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"ocrText": "miss\nMrs\nForm 170\nMEDICAL DEPARTMENT, U.S.A.\nARMY NURSE CORPS\n(Authorized Feb. 15, 1943)\nApplication for Appointment\nJ.\n1. Name Cartier,\nJune\narjeanne\nDuShane\nF\n(Print or type all\n(Last name)\n(First name)\n(Middle name)\n(Maiden name)\non this line)\n2.\nPermanent address 308 Hungerford Ave,\nMarquette\nMichigan\n(Street)\n(City)\n(County)\n(State)\n3. Probable address for one year 308 Hungerford Ave,\nMarquette\nMichigan\n(Street)\n(City)\n(County)\n(State)\n4. Name and permanent address of nearest relative or friend residing in the United States:\nParents Mr. &c Mrs. Frank DuShane, 308 Hungerford Ave,\nRelationship\n(Name)\n5.\nNegaunee, (Address)\nRace\nNationality\nMarital status\nU. S. citizenship\nWhat languages other than English do you speak?\n(Specify)\nWhite\nSingle\nWidowed\nNative born\nFinnish\nNegro\nMarried\nSeparated\nNaturalized\nOther\nDivorced\nNoncitizen\n6. If divorced, attach copy of documentary evidence.\n7. If naturalized citizen, give date, number, and place of naturalization certificate\na\nS\n8. If not a citizen of the United States, of what country are you a citizen?\n9. Date of birth August 31\n1920\n10. Place of birth\nIshpeming, Michigan\n(Month)\n(Year)\nP\n(Day)\n11. Is father a citizen of the U. S. A.? Yes\nNo\n12. Country of birth of father United States\nS\n13. If married, give husband's full name\nSergeant Albert Jean Cartier\n14. Permanent address of husband\n7 Rose Street, Haverhill, Mass.\ne\n15. Is your husband a member of the armed forces? Yes No\nIf so, what branch of the service and what grade does he\nhold in that branch?\nSergeant- Post Headquarters, Personnel Section\nList names of minor children, giving age of each:\n16. Has adequate care been provided for minor children for the duration of the war plus 6 months thereafter?\n17. What is your height in inches?\n5 ft. 4 in.\n18. Your weight in pounds? 175lbs.\n19. Have you had any of the following? If so, state when and degree of incapacity.\nDisease of the nasal sinuses\nNervous breakdown\nTuberculosis\nMenstrual disturbance\nNone\n20. Major operations or serious injury (specify)\nNone\n(A complete physical examination will be given before assignment)\nNo\n21. Have you given up any pursuit on account of ill health? If so, state particulars\n22. In what State or States are you registered? Michigan - Territory of Hawaii Year\n1942-,,1945\n1963-Hawail\nI\n23. Number of Registration Certificate 30645\n24. Are you registered for the current year? Yes\nNo\n25. Of what nursing organizations are you a member? Alumnae, District, State, American ASsoiations Nursing\n26. Have you ever been arrested for other than minor traffic violations? If so, state particulars\nNo\n27. Have you ever been served with a subpena? Yes\nNo\n16-33343-1"
}