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I
PHYSICAL CONDITION
MADIR3MA
Have you been rejected for military service by:
The Army Nurse Corps Yes
No
The Navy Nurse Corps? Yes
No
When ?
Why ? Q AAUNNA
e
Do you believe that you could now meet physical requirements for military service? Yes
No
What is your present physical condition
?
good
5
If
any
disabilities, please specify Some achhitis
n
If you have had additional study since filing your 1943 Red Cross questionnaire give the type of course
and the length of time included:
If you did NOT file a Red Cross annual questionnaire in 1943 please answer the following questions:
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?
Did you have a five-year nursing course granting a bachelor's degree? Yes
No
AFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have:
1.
A postgraduate course (at least 3 months in a hospital) or experience (at least 6 months in
a
hospital) in any of the following services?
Course
Number of months
Experience
Number of months
Communicable disease nursing
(includes tuberculosis)
Psychiatric nursing
Operating room
years
Anaesthesia
29 years
2. Any courses in a college or university ? (Check in box.)
Less than one
One
Two
Three
Four
Bachelor's
Master's
Ph.D.
M.D.
academic year
year
years
years
years
degree
degree
degree
degree
In what major field was the above study ?
3. Experience or training in the public health field? Experience, 6 months or more
Postgraduate course, 4 months or more
Certificate
Degree
Jemine Pauline (signature) Hoagland fan (date this 19th form is filled in) 1944
YOUR VALUE AS A RED CROSS RESERVE NURSE DEPENDS ON OUR ABILITY TO LOCATE YOU.
THE WORLD CRISIS EMPHASIZES THIS NEED MORE THAN EVER. THANK YOU FOR FILLING
IN THIS QUESTIONNAIRE AND RETURNING IT PROMPTLY TO THE COMMITTEE NAMED BELOW.
To be filled in by the committee before the questionnaire is sent to the nurse.
JOSEPHINE A. OHLSON, R. N.
CORRESPONDING SECRETARY
Chicago-Chapter, Ameriean--Red-Gross
(Name of the committee to whom this questionnaire is to be returned)
529 S. WABASH AVENUE
CHICAGO 5, ILLINOIS
(street)
(city)
(state)
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Document data
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"ocrText": "I\nPHYSICAL CONDITION\nMADIR3MA\nHave you been rejected for military service by:\nThe Army Nurse Corps Yes\nNo\nThe Navy Nurse Corps? Yes\nNo\nWhen ?\nWhy ? Q AAUNNA\ne\nDo you believe that you could now meet physical requirements for military service? Yes\nNo\nWhat is your present physical condition\n?\ngood\n5\nIf\nany\ndisabilities, please specify Some achhitis\nn\nIf you have had additional study since filing your 1943 Red Cross questionnaire give the type of course\nand the length of time included:\nIf you did NOT file a Red Cross annual questionnaire in 1943 please answer the following questions:\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?\nDid you have a five-year nursing course granting a bachelor's degree? Yes\nNo\nAFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have:\n1.\nA postgraduate course (at least 3 months in a hospital) or experience (at least 6 months in\na\nhospital) in any of the following services?\nCourse\nNumber of months\nExperience\nNumber of months\nCommunicable disease nursing\n(includes tuberculosis)\nPsychiatric nursing\nOperating room\nyears\nAnaesthesia\n29 years\n2. Any courses in a college or university ? (Check in box.)\nLess than one\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\nM.D.\nacademic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was the above study ?\n3. Experience or training in the public health field? Experience, 6 months or more\nPostgraduate course, 4 months or more\nCertificate\nDegree\nJemine Pauline (signature) Hoagland fan (date this 19th form is filled in) 1944\nYOUR VALUE AS A RED CROSS RESERVE NURSE DEPENDS ON OUR ABILITY TO LOCATE YOU.\nTHE WORLD CRISIS EMPHASIZES THIS NEED MORE THAN EVER. THANK YOU FOR FILLING\nIN THIS QUESTIONNAIRE AND RETURNING IT PROMPTLY TO THE COMMITTEE NAMED BELOW.\nTo be filled in by the committee before the questionnaire is sent to the nurse.\nJOSEPHINE A. OHLSON, R. N.\nCORRESPONDING SECRETARY\nChicago-Chapter, Ameriean--Red-Gross\n(Name of the committee to whom this questionnaire is to be returned)\n529 S. WABASH AVENUE\nCHICAGO 5, ILLINOIS\n(street)\n(city)\n(state)"
}