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- the 2nd bc Form 1045 Rev. Nov. 1942 D AMERICAN RED CROSS NURSING SERVICE If you have changed your last name since Carter a contacting us, please check here Name in full (last) manny Tel. No. alex-3079 M (first) (middle) If married, give maiden name Date of birth Jan 27,1881 Marital status Husband's name (single, married, widowed, divorced) Permanent address 311- So. St. asaph alexandrea (street) (city) (county) braganic state) Probable address for the next year same (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: Mrs G.H.Carter mortur 714- Gueen St. alefandre be (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 Industrial Private duty Other (write in) Government Clerk 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 x 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? none 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? M. D. Less than One Two Three Four Bachelor's Master's Ph.D. one academic year year years years years degree degree degree degree In what major field was above study? 3. Training and experience in the public health field: Postgraduate months or more 11 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": "-\nthe\n2nd\nbc\nForm 1045\nRev. Nov. 1942\nD\nAMERICAN RED CROSS\nNURSING SERVICE\nIf you have changed your last name since\nCarter\na\ncontacting us, please check here\nName in full\n(last)\nmanny\nTel. No. alex-3079\nM\n(first)\n(middle)\nIf married, give maiden name\nDate of birth Jan 27,1881\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address 311- So. St. asaph alexandrea\n(street)\n(city)\n(county)\nbraganic\nstate)\nProbable address\nfor the next year\nsame\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nMrs G.H.Carter\nmortur\n714- Gueen St. alefandre be\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\nIndustrial\nPrivate duty\nOther (write in)\nGovernment Clerk\nGovernment Service: Army, 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\nx\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?\nnone\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?\nM. D.\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\none academic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was above study?\n3. Training and experience in the public health field: Postgraduate months or more\n11\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)"
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