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12. PROFESSIONAL AFFILIATIONS: Illinois State Nurses Association Of what State Nurses' Association are you a member?* If you have only recently applied for membership, to whom did you pay your dues? (Name) (Title and organization) (Address) In what State are you registered? Illinois Year of registration 1927 13. Present Position: Anesthetist, c/o Dr. Ralph B. Rode, 906 Olive St., St. Louis, Mo. Field of Nursing Major Responsibilities Institutional Private Duty 1 Administration General Duty 2 Public Health Other (specify below) 2 Supervision Private Duty Industrial Anesthesia Teaching Other (Specify below) Anesthesia 14. Give in order positions held since graduation. Star present position: Position Organization or Hospital City State Dates Anesthetist Baptist Hospital Memphis, Tenn. Tel.,1979-1932 " Water Valley Hospital, Water valley, Miss. Jare 1932 Sept 34 " Mo. Pacific Hospital St. Louis Mo. 1. Relief avaco 11 Litchfield Co. Hosp. Winsted, Conn. Religion 11 / Hurley Hospital Flint, Mich. July 13,1937.0pr 1959 " " Ur. Ralph B. Rode St. Louis Mo. Norrel 1935 1934 15. Red Cross Status: april 20.19 1939; Are you willing to take the oath of allegiance? Yes present pasiling Are you planning to teach the course in Red Cross Home Nursing? No If not, would you like to teach it? No Although I understand my response at the time of a call is voluntary, by applying for enrollment I signify that I wish to make myself available for the emergency nursing needs of my country. I understand that this may mean service with the Red Cross, or, in the event of such a national disaster as war, with the Army or Navy. For military assignment I prefer the 1 Army Nurse Corps; 2 Navy Nurse Corps, Either as needed. I will be available for service in the near future ; Date available National emergency Date January 1942 Signature of nurse. Virginia Dael Membership in a District Nurses' Association carries with it membership in the State Nurses' Association and the American Nurses' Membership in your Alumnae Association, provided you live in the District in which it is located, carries with it membership in the State Nurses' Association and the American Nurses' Association. Australial OK SPACE BELOW TO BE FILLED IN BY COMMITTEE PLEASE DO NOT USE THIS SPACE S APPROVED The recommendations of the Local Committee on Red Cross Nursing Service should be indicated below, over the signature of at least two members of the Com- mittee. Mary Beard Director, Red Cross Nursing Service 121-133 APPROVED: NOT APPROVED: mairiem.moore Inn. Selfinance Name of Committee St. 96318 FEB Date 6'42 Date Til 2-42 No Enrolled FEB 1000

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Page context
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    "ocrText": "12. PROFESSIONAL AFFILIATIONS:\nIllinois State Nurses Association\nOf what State Nurses' Association are you a member?*\nIf you have only recently applied for membership, to whom did you pay your dues?\n(Name)\n(Title and organization)\n(Address)\nIn what State are you registered?\nIllinois\nYear of registration\n1927\n13. Present Position: Anesthetist, c/o Dr. Ralph B. Rode, 906 Olive St., St. Louis, Mo.\nField of Nursing\nMajor Responsibilities\nInstitutional\nPrivate Duty\n1 Administration\nGeneral Duty\n2\nPublic Health\nOther (specify below)\n2 Supervision\nPrivate Duty\nIndustrial\nAnesthesia\nTeaching\nOther (Specify below)\nAnesthesia\n14. Give in order positions held since graduation. Star present position:\nPosition\nOrganization or Hospital\nCity\nState\nDates\nAnesthetist\nBaptist Hospital Memphis, Tenn.\nTel.,1979-1932\n\"\nWater Valley Hospital, Water valley, Miss. Jare 1932 Sept 34\n\"\nMo. Pacific Hospital St. Louis\nMo.\n1.\nRelief avaco\n11\nLitchfield Co. Hosp. Winsted, Conn.\nReligion\n11\n/\nHurley Hospital\nFlint, Mich.\nJuly 13,1937.0pr 1959\n\"\n\"\nUr. Ralph B. Rode\nSt. Louis\nMo. Norrel 1935 1934\n15. Red Cross Status:\napril 20.19 1939;\nAre you willing to take the oath of allegiance?\nYes\npresent pasiling\nAre you planning to teach the course in Red Cross Home Nursing?\nNo\nIf not, would you like to teach it?\nNo\nAlthough I understand my response at the time of a call is voluntary, by applying for enrollment I signify that I wish to\nmake myself available for the emergency nursing needs of my country. I understand that this may mean service with\nthe Red Cross, or, in the event of such a national disaster as war, with the Army or Navy. For military assignment I prefer\nthe\n1 Army Nurse Corps;\n2\nNavy Nurse Corps,\nEither as needed. I will be available for service in the near\nfuture\n; Date available\nNational emergency\nDate\nJanuary\n1942\nSignature of nurse. Virginia Dael\nMembership in a District Nurses' Association carries with it membership in the State Nurses' Association and the American Nurses'\nMembership in your Alumnae Association, provided you live in the District in which it is located, carries with it membership in the State Nurses'\nAssociation and the American Nurses' Association.\nAustralial\nOK\nSPACE BELOW TO BE FILLED IN BY COMMITTEE\nPLEASE DO NOT USE THIS SPACE\nS\nAPPROVED\nThe recommendations of the Local Committee on\nRed Cross Nursing Service should be indicated below,\nover the signature of at least two members of the Com-\nmittee.\nMary Beard\nDirector, Red Cross Nursing Service\n121-133\nAPPROVED:\nNOT APPROVED:\nmairiem.moore\nInn. Selfinance\nName of Committee St.\n96318 FEB Date 6'42\nDate\nTil 2-42\nNo\nEnrolled\nFEB 1000"
}