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DMR1
THE AMERICAN RED CROSS
DEPARTMENT OF NURSING
ar
Application for Enrollment
(To be filled out entirely in applicant's handwriting and each question answered fully)
1. Name
of applicant in full Marion Cartmell
2.
Address in full, Street. 476nmmin City Wilkes-Bane State Penna
H
3. Date of birth October 11 1879
Place of birth Lehman Lugerne Cr.Pa.
4. Are you married, single or a widow? Single Are you a citizen of no the United States? yes
M
5. Have you any physical defects or tendency to constitutional or pulmonary trouble?
Are you physically strong and healthy? yes
6.
Name educational institutions attended before entering training school, stating number of years at each and from
which you were graduated Wilkes-Bane High school
7. What languages other than English do you speak? not any
8. Occupation before entering training school
not any
ON
9.
City and state Wilber-Banic Penna
From what hospital training school did you receive your diploma? wilkes Bane City Hospital
Date of graduation Marshile 1902.
10. Character of hospital: General? yes.
Special?
Private?
11. Did your training include obstetrics yes Care of men yes culture Children Contagious diseases? no
12. Daily average number of patients in hospital during training One Length of course Two years
13. Name and address of superintendent of training school under whom you received training
miss Roberta West lak Lane Poteffice Phila Penna
14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each. 4mmits
Yook special training in obstetics in new-ynb Infirmany
15.
the and State nurses associations Penna
Of what nursing organizations are you a member? wilkes Barre city Hospital alidmance asch.
16. Which, if any, is affiliated with the American Nurses Association? State nursis association Penns
17. Give
Scranton Perma Miss Hisheymona Dimeleu. Pittsburg Pa
name and address of secretary of, at least one of these organizations missfurrd Staty Hispital
18. Are you a registered nurse yes In what state? inna Date of registration fan 1910 Number
19. How and where employed since graduation :
Give dates with months.
Name and address of employers:
Have done private
mirsing in Wilkis-Bane
since graduation
(Specify for which of the following services you wish to be considered.)
20.
War service, wherever needed yes frign preferred When available September 1918
Are you willing to take the oath of allegiance? yes
21. Instructor, Elementary Hygiene
2
22. Public Health Nursing
In Town and Country Nursing Service.
or for War Service yes
23. Name and permanent address of nearest relative. Mrs Harriet H Cartmell (mother)
476 n main st Wilkes- Bane Penna
Date may 30. 1918
Signature of Nurse manin Cartmell
To the Committee:
This blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, 11, 29, and A. R. C.
703. Application forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval
and endorsement by Local Committee, with credentials (Forms 3 and 4), together with Forms 10, 11 and 29, should be
for-
warded to the Chairman, Department of Nursing, American Red Cross, Washington, D. C.
In case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the
Local Committee, instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the
Local Committee. from whence credentials will be procured.
IM-March
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Document data
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"ocrText": "DMR1\nTHE AMERICAN RED CROSS\nDEPARTMENT OF NURSING\nar\nApplication for Enrollment\n(To be filled out entirely in applicant's handwriting and each question answered fully)\n1. Name\nof applicant in full Marion Cartmell\n2.\nAddress in full, Street. 476nmmin City Wilkes-Bane State Penna\nH\n3. Date of birth October 11 1879\nPlace of birth Lehman Lugerne Cr.Pa.\n4. Are you married, single or a widow? Single Are you a citizen of no the United States? yes\nM\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble?\nAre you physically strong and healthy? yes\n6.\nName educational institutions attended before entering training school, stating number of years at each and from\nwhich you were graduated Wilkes-Bane High school\n7. What languages other than English do you speak? not any\n8. Occupation before entering training school\nnot any\nON\n9.\nCity and state Wilber-Banic Penna\nFrom what hospital training school did you receive your diploma? wilkes Bane City Hospital\nDate of graduation Marshile 1902.\n10. Character of hospital: General? yes.\nSpecial?\nPrivate?\n11. Did your training include obstetrics yes Care of men yes culture Children Contagious diseases? no\n12. Daily average number of patients in hospital during training One Length of course Two years\n13. Name and address of superintendent of training school under whom you received training\nmiss Roberta West lak Lane Poteffice Phila Penna\n14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each. 4mmits\nYook special training in obstetics in new-ynb Infirmany\n15.\nthe and State nurses associations Penna\nOf what nursing organizations are you a member? wilkes Barre city Hospital alidmance asch.\n16. Which, if any, is affiliated with the American Nurses Association? State nursis association Penns\n17. Give\nScranton Perma Miss Hisheymona Dimeleu. Pittsburg Pa\nname and address of secretary of, at least one of these organizations missfurrd Staty Hispital\n18. Are you a registered nurse yes In what state? inna Date of registration fan 1910 Number\n19. How and where employed since graduation :\nGive dates with months.\nName and address of employers:\nHave done private\nmirsing in Wilkis-Bane\nsince graduation\n(Specify for which of the following services you wish to be considered.)\n20.\nWar service, wherever needed yes frign preferred When available September 1918\nAre you willing to take the oath of allegiance? yes\n21. Instructor, Elementary Hygiene\n2\n22. Public Health Nursing\nIn Town and Country Nursing Service.\nor for War Service yes\n23. Name and permanent address of nearest relative. Mrs Harriet H Cartmell (mother)\n476 n main st Wilkes- Bane Penna\nDate may 30. 1918\nSignature of Nurse manin Cartmell\nTo the Committee:\nThis blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, 11, 29, and A. R. C.\n703. Application forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval\nand endorsement by Local Committee, with credentials (Forms 3 and 4), together with Forms 10, 11 and 29, should be\nfor-\nwarded to the Chairman, Department of Nursing, American Red Cross, Washington, D. C.\nIn case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the\nLocal Committee, instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the\nLocal Committee. from whence credentials will be procured.\nIM-March"
}