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a
<
Form 1045
Rev. Nov. 1941
AMERICAN RED CROSS
NURSING SERVICE
M
Name in full
Davis
Mary
Thornton
Tel. No. home 4829 Mass
office 6969 Greening
a
(last)
(first)
(middle)
If married, give maiden name -
Year of birth 1890
Marital status
single
-
Husband's name
(single, martied, widowed, divorced)
Permanent address (22 her St. maiblebead ussex
mass
mothers address )
(street)
(county)
(state)
we Green
(city)
Probable address
firedrunders
for the next year
8 H figh (street) SV greenpeld (city) Frauklin (county) mass (state)
morified
office 14, tope SV.
Give name and address of nearest relative or friend in United States:
Mrs. Francis de Lancey Cunninsham (relationship) (Sister) 64So (address) mountain Rd Pittsfied mans.
(name)
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
quantied Visiting nurse Association - 14 Hope Sv.tl.6969
Industrial
Private duty
Other (write in)
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
General Staff
Other (specify)
How many years did you attend HIGH SCHOOL? One
Two
Three
Four
Graduated
Private schools. - equin to lys. Collige
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-hoopital
in a hospital
or public health field
(at least 3 months)
(at least 6 months)
Communicable disease nursing (include Tbc)
Psychiatric Nursing
Operating room
Public health nursing 8mos. Teacheis College, Columbiats. n.4.
Anaesthesia
25 years
a
2. Have you taken any courses in a college or university?
Less than
One
Two
Three
Four
Bachelor's
Master's
P.H.D.
Certificate in
*one year
year
years
years
years
degree
degree
degree
Public Health
2
days /
6
In what major was
field above study? Public Health nursing
0
What languages, other than English, do you speak? none fluantty. no practice since 1920
RJ
was able to make my self understood is French & to Extent in anthover) ettalian
8
* Academic year
Studied trucht german in School about 10 grant could get long
aither about 1910.
Page data
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- Source index
- 0
- Type
- photo
- Media ID
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- Size
- unknown
Document data
- ID
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- Core
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- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "D\na\n<\nForm 1045\nRev. Nov. 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nM\nName in full\nDavis\nMary\nThornton\nTel. No. home 4829 Mass\noffice 6969 Greening\na\n(last)\n(first)\n(middle)\nIf married, give maiden name -\nYear of birth 1890\nMarital status\nsingle\n-\nHusband's name\n(single, martied, widowed, divorced)\nPermanent address (22 her St. maiblebead ussex\nmass\nmothers address )\n(street)\n(county)\n(state)\nwe Green\n(city)\nProbable address\nfiredrunders\nfor the next year\n8 H figh (street) SV greenpeld (city) Frauklin (county) mass (state)\nmorified\noffice 14, tope SV.\nGive name and address of nearest relative or friend in United States:\nMrs. Francis de Lancey Cunninsham (relationship) (Sister) 64So (address) mountain Rd Pittsfied mans.\n(name)\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nquantied Visiting nurse Association - 14 Hope Sv.tl.6969\nIndustrial\nPrivate duty\nOther (write in)\nGovernment Service:\nArmy, 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\nGeneral Staff\nOther (specify)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nPrivate schools. - equin to lys. Collige\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-hoopital\nin a hospital\nor public health field\n(at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include Tbc)\nPsychiatric Nursing\nOperating room\nPublic health nursing 8mos. Teacheis College, Columbiats. n.4.\nAnaesthesia\n25 years\na\n2. Have you taken any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\n*one year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\nPublic Health\n2\ndays /\n6\nIn what major was\nfield above study? Public Health nursing\n0\nWhat languages, other than English, do you speak? none fluantty. no practice since 1920\nRJ\nwas able to make my self understood is French & to Extent in anthover) ettalian\n8\n* Academic year\nStudied trucht german in School about 10 grant could get long\naither about 1910."
}