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I C B 2nd Form 1045 Rev. Nov. 1942 OKA woras AMERICAN RED CROSS 1 NURSING SERVICE DC Boston metro a Du Brau class Edeth If you have changed your last name since contacting us, please check here Name in full (last) (first) (middle) Tel. NoNeumere 0950 If married, give maiden name Date of birth July 13-1002 C Marital status Husband's name (single, married, widowed, divorced) Permanent address 839 (street) Boylston (city) Bostne Mariachusetts (county) (state) Probable address for the next year 739Boylstore Boston / massachusetts (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: sester (name) (relationship) Central th (address) Harragawett Peir R.J. E Are you employed in nursing at the present time? Yes No PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed d Institutional + Public health 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 ITLIGANATA 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 Private Three Four Duz Graduated Yes No Before entering training, how many years did you attend COLLEGE? Egetinalist Did you have a five-year course granting bachelor's degree? 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) 4

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    "ocrText": "I\nC\nB\n2nd\nForm 1045\nRev. Nov. 1942\nOKA woras\nAMERICAN RED CROSS\n1\nNURSING SERVICE\nDC\nBoston metro\na\nDu Brau class Edeth\nIf you have changed your last name since\ncontacting us, please check here\nName in full\n(last)\n(first)\n(middle)\nTel. NoNeumere 0950\nIf married, give maiden name\nDate of birth July 13-1002\nC\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address 839 (street) Boylston (city) Bostne\nMariachusetts\n(county)\n(state)\nProbable address\nfor the next year 739Boylstore Boston\n/\nmassachusetts\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nsester\n(name)\n(relationship)\nCentral th (address) Harragawett Peir R.J.\nE\nAre you employed in nursing at the present time?\nYes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nd\nInstitutional\n+\nPublic health\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\nITLIGANATA\nMAJOR RESPONSIBILITIES\nAdministration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral staff\nOther (specify)\nIf not employed, what type of nursing would you prefer to render?\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo Private Three Four Duz Graduated\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE?\nEgetinalist\nDid you have a five-year course granting bachelor's degree?\nAFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-\nPostgraduate course\nin a hospital\nExperience in hospital\n1. A postgraduate course or experience in any of the following services? (at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include tuberculosis)\nPsychiatric nursing\nOperating room\nAnaesthesia\n2. Have you had any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\nM. D.\none academic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was above study?\n3. Training and experience in the public health field: Postgraduate 4 months or more\nCertificate\nDegree\nExperience 6 months\nHave you ever held a position as an air hostess?\nYes\nNo\nHow long?\nHave you ever had any other air experience?\nYes\nNo\nSpecify\n(OVER)\n4"
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