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II
a
not on No 2 card
and
- Form 1045
AHT
x
Rev. Nov. 1942
CIVA worm AMERICAN RED CROSS
av
M
KOB
NURSING SERVICE
an
If you have changed your last name since
S
S.
TS
Cox
contacting us, please check here
Name in full Hare
Nan
G.
Tel. No. 6-6181 Ed.316
:-
(last)
(first)
(middle)
If married, give maiden name
Date of birth
N
Dicorced
Marital status
Husband's name
(single, married,
Permanent address
Scott
disgina
D
an
(street)
(eity)
(county)
(state)
Probable address
use due above or TLG chalta nooga Team.
u
5
for the next year
(street)
(city)
(county)
(state)
a
-
Give name and address of nearest relative or friend in United States;
e
Mrs. games (name) m. Cox (mother) (relationship)
fort Blockmore, ba.
e
(address)
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
Too - chalta nouga Team
0
J.
Private duty
x
Other (write in)
Government Service:
Army, Regular
Navy, Regular
Veterans Administration
R.
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? June Home B. S. 1934
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
to
old
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
is
In what major field was above study? jublic Health nursing
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)
Page data
- Page
- 20
- Source index
- 0
- Type
- photo
- Media ID
- b35c37c1641c7852
- Size
- unknown
Document data
- ID
- 2661588
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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Page context
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"ocrText": "II\na\nnot on No 2 card\nand\n- Form 1045\nAHT\nx\nRev. Nov. 1942\nCIVA worm AMERICAN RED CROSS\nav\nM\nKOB\nNURSING SERVICE\nan\nIf you have changed your last name since\nS\nS.\nTS\nCox\ncontacting us, please check here\nName in full Hare\nNan\nG.\nTel. No. 6-6181 Ed.316\n:-\n(last)\n(first)\n(middle)\nIf married, give maiden name\nDate of birth\nN\nDicorced\nMarital status\nHusband's name\n(single, married,\nPermanent address\nScott\ndisgina\nD\nan\n(street)\n(eity)\n(county)\n(state)\nProbable address\nuse due above or TLG chalta nooga Team.\nu\n5\nfor the next year\n(street)\n(city)\n(county)\n(state)\na\n-\nGive name and address of nearest relative or friend in United States;\ne\nMrs. games (name) m. Cox (mother) (relationship)\nfort Blockmore, ba.\ne\n(address)\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\nPublic health\nIndustrial\nToo - chalta nouga Team\n0\nJ.\nPrivate duty\nx\nOther (write in)\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nR.\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES Administration\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\nThree\nFour\nGraduated\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE? June Home B. S. 1934\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\nto\nold\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\nis\nIn what major field was above study? jublic Health nursing\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)"
}