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app. dxf. sent in care of miss Charlest 3046-90
C
FORM NO. 1
AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
1.
Name
of applicant Marie 7 Catains
Badge number
2. Address in full
1333 Respengton Cornur
3.
Date of
birth april 11-1889 Place of birth New y orh City
ari
4.
Are you margied, single or a widow? Single Are you a citizen of the United States? yes
5. Have you any physical defects or tendency to constitutional or pulmonary trouble?
no
F
6. Name educational institutions attended before entering training school, stating number of years at each and
from which you were graduated
P. 8. 114 and P.S.T from the agr of 6-to 16 -
7. at home
graduated from to coller
Occupation before entering training school
8. From what hospital training school were you graduated? Give location of hospital and date of graduation
The Halias Hospital Fool of 83"St May 11-1911
9. Character of hospital: General yes Special
Private?
10. Daily average number of patients in hospital during training 100 Length of course
11. Name and address of superintendent of training school under whom you received training
12.
Of what nursing organizations are you a member ?. The Italian Hospital alumi
Miss A S. Wright address unknown
expect IN affiliatediate the CV. y Country regis bries nurse is the
fail -
13. Give and address of of at least one of these organizations
Miss name Pantescs secretary H18 Wesh 40 "st:
14. Are you a registered nurse ? yes In what state ? N.Y. Date of registration may 5-1911
15. State how, where and for what period of time, in each instance, you have been employed since graduation,
including present employment
/
al Haffman's Alland Puraraute sta- from June 1912
February 1912. to June 1912 Post Graduals Course
June 1912 Jan 1914 Private nursery gan 1914 to Hoof
present date Board of Health nurse
5
16. 17. In the event of war are you willing of nearest relative Min allegiance my yesrande
to take the oath of ?
U
Name and permanent address
3
224 Eighty avenue
Signaturer. Maris 7 Catacus
of
Date aug 24- 14
This blank is to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee
to be forwarded with "credentials" (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D. c.
Page data
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- Source index
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- Type
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Document data
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- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "app. dxf. sent in care of miss Charlest 3046-90\nC\nFORM NO. 1\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\n1.\nName\nof applicant Marie 7 Catains\nBadge number\n2. Address in full\n1333 Respengton Cornur\n3.\nDate of\nbirth april 11-1889 Place of birth New y orh City\nari\n4.\nAre you margied, single or a widow? Single Are you a citizen of the United States? yes\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble?\nno\nF\n6. Name educational institutions attended before entering training school, stating number of years at each and\nfrom which you were graduated\nP. 8. 114 and P.S.T from the agr of 6-to 16 -\n7. at home\ngraduated from to coller\nOccupation before entering training school\n8. From what hospital training school were you graduated? Give location of hospital and date of graduation\nThe Halias Hospital Fool of 83\"St May 11-1911\n9. Character of hospital: General yes Special\nPrivate?\n10. Daily average number of patients in hospital during training 100 Length of course\n11. Name and address of superintendent of training school under whom you received training\n12.\nOf what nursing organizations are you a member ?. The Italian Hospital alumi\nMiss A S. Wright address unknown\nexpect IN affiliatediate the CV. y Country regis bries nurse is the\nfail -\n13. Give and address of of at least one of these organizations\nMiss name Pantescs secretary H18 Wesh 40 \"st:\n14. Are you a registered nurse ? yes In what state ? N.Y. Date of registration may 5-1911\n15. State how, where and for what period of time, in each instance, you have been employed since graduation,\nincluding present employment\n/\nal Haffman's Alland Puraraute sta- from June 1912\nFebruary 1912. to June 1912 Post Graduals Course\nJune 1912 Jan 1914 Private nursery gan 1914 to Hoof\npresent date Board of Health nurse\n5\n16. 17. In the event of war are you willing of nearest relative Min allegiance my yesrande\nto take the oath of ?\nU\nName and permanent address\n3\n224 Eighty avenue\nSignaturer. Maris 7 Catacus\nof\nDate aug 24- 14\nThis blank is to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee\nto be forwarded with \"credentials\" (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D. c."
}