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J FORM 843-A Eastern REV. 3-1-22 Branch PUBLIC HEALTH NURSES RESIGNATION SLIP Dalton, Bess 39712 Name Enrol. No. Chesterfield So.Car. Resigned from (NAME OF CHAPTER OR SERVICE) (CITY) (STATE) B DATES Salary at resignation 144 (b Assigned (TO ABOVE SERVICE) Reason for resignation Itin. transfer S Resigned Transferred Itin. 7-4-33 Dismissed III - L Desirability for future appointment 7 (This should be accompanied by Form 852)

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