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N D ee- e (A S & I/C Form 1045 Rev. Nov. 1942 L CIVA wous AMERICAN RED CROSS zoa Fresno Co, TMIT en NURSING SERVICE M If you have changed your last name since 1 contacting us, please check here Name in full Disney (last) (first) (middle) Mosher - Tel. No Lurry fan 276 S. If married, give maiden name mosher Date of birth Seps 30 1892 E Marital status (single, married, widowed, divorced) Permanent address (street) Delhi (city) mered (county) (state) Colif Husband's name Charles Disney L Probable address H, for the next year same 5 (street) (city) (county) (state) or Give name and address of nearest relative or friend in United States: Pristand Delhi (relationship) Mean e (name) - (address) Are you employed in nursing at the present time? Yes No is + PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed n Institutional rb Public health 1 I 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) If not employed, what type of nursing would you prefer to render? How many years did you attend HIGH SCHOOL? One Two Three Four Graduated Yes No Before entering training, how many years did you attend COLLEGE? name Did you have a five-year course granting bachelor's degree? no AFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-- Postgraduate course in a hospital Experience in hospital 1. A postgraduate course or experience in any of the following services? (at least 3 months) (at least 6 months) Communicable disease nursing (include tuberculosis) Psychiatric nursing Operating room Anaesthesia 2. Have you had any courses in a college or university? Less than One Two Three Four Bachelor's Master's Ph.D. M. D. one academic year year years years years degree degree degree degree In what major field was above study? 3. Training and experience in the public health field: Postgraduate 4 months or more Certificate Degree Experience 6 months Have you ever held a position as an air hostess? Yes No How long? Have you ever had any other air experience? Yes No Specify . (OVER)

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15
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0
Type
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4d0acc55132a5888
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Document data

ID
2661368
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Type
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Context sent to Scholar

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Page context
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