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Form 1045
Rev. Nov. 1941
AMERICAN RED CROSS
JAN 21942
NURSING SERVICE
exe
Name in full
DANIELSON
IDA
WILMYNA
Tel. No. WABASH 4400
(last)
(first)
(middle)
H
If married, give maiden name
Single
Year of birth
1891
a
Marital status
Single
Husband's name
--
a
(single, married, widowed, divorced)
Permanent address
--
Walnut Grove
Redwood
Minnesota
(street)
(city)
(county)
(state)
Probable address
for the next year
Stevens Hotel
Chicago
Cook
Illinois
/
I
(street)
(city)
(county)
(state)
-
Give name and address of nearest relative or friend in United States:
Mrs., T. W. Prail
Sister
WalnutGrove. Minnesota
(name)
(relationship)
(address)
in
Are you employed in nursing at the present time? Yes
No
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
5
a
Institutional
Public health
Industrial
Private duty
Other (write in)
I
Veterans Administration
Government Service: Army, Regular
Navy, Regular
Reserve
Reserve
Children's Bureau
U.S.P.H. Service
U.S. Indian Service
MAJOR RESPONSIBILITIES
Administration
Teaching
Private duty
of present employment
Supervision
General Staff
Other (specify)
How many years did you attend HIGH SCHOOL? One
Two
Three
Four
Graduated
Yes
No
SINCE GRADUATION FROM YOUR SCHOOL OF NURSING
have you ever had-
1. A postgraduate course or experience in any of the following special services?
Postgraduate course
Experience in hospital
in a hospital
V ox Rublig hoakth
(at least 3 months)
(at least 6 months)
1 yr PG
Communicable disease nursing (include Tbc)
study Mayo
Psychiatric Nursing
Clinic, 1917-
1918
Operating room
Anaesthesia
Public health nursing
2. Have you taken any courses in a college or university?
Less than
One
Three
Four
Bachelor's
Master's
P.H.D.
Certificate in
Two
years
degree
degree
Public Health
'one year
year
years
years
degree
In what major field was above study?
--
the
What languages, other than English, do you speak?
None
(Understand considerable German, cannot
speak it)
(OVER)
*Academic year
Page data
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- Source index
- 0
- Type
- photo
- Media ID
- aa85ce26bf7438a0
- Size
- unknown
Document data
- ID
- 2661306
- Core
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- Type
- document
DTO data
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"ocrText": "Form 1045\nRev. Nov. 1941\nAMERICAN RED CROSS\nJAN 21942\nNURSING SERVICE\nexe\nName in full\nDANIELSON\nIDA\nWILMYNA\nTel. No. WABASH 4400\n(last)\n(first)\n(middle)\nH\nIf married, give maiden name\nSingle\nYear of birth\n1891\na\nMarital status\nSingle\nHusband's name\n--\na\n(single, married, widowed, divorced)\nPermanent address\n--\nWalnut Grove\nRedwood\nMinnesota\n(street)\n(city)\n(county)\n(state)\nProbable address\nfor the next year\nStevens Hotel\nChicago\nCook\nIllinois\n/\nI\n(street)\n(city)\n(county)\n(state)\n-\nGive name and address of nearest relative or friend in United States:\nMrs., T. W. Prail\nSister\nWalnutGrove. Minnesota\n(name)\n(relationship)\n(address)\nin\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\n5\na\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\nI\nVeterans Administration\nGovernment Service: Army, Regular\nNavy, Regular\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES\nAdministration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral Staff\nOther (specify)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nYes\nNo\nSINCE GRADUATION FROM YOUR SCHOOL OF NURSING\nhave you ever had-\n1. A postgraduate course or experience in any of the following special services?\nPostgraduate course\nExperience in hospital\nin a hospital\nV ox Rublig hoakth\n(at least 3 months)\n(at least 6 months)\n1 yr PG\nCommunicable disease nursing (include Tbc)\nstudy Mayo\nPsychiatric Nursing\nClinic, 1917-\n1918\nOperating room\nAnaesthesia\nPublic health nursing\n2. Have you taken any courses in a college or university?\nLess than\nOne\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\nTwo\nyears\ndegree\ndegree\nPublic Health\n'one year\nyear\nyears\nyears\ndegree\nIn what major field was above study?\n--\nthe\nWhat languages, other than English, do you speak?\nNone\n(Understand considerable German, cannot\nspeak it)\n(OVER)\n*Academic year"
}