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DMR1
THE AMERICAN RED CROSS
I
NURSING SERVICE
Application for Enrollment
e.
(To be filled out entirely in applicant's handwriting and each question answered fully)
I. Name of applicant in full
Cora FlorRie Hobein
2. Address in full, Street siling
City Hunani
State. China
0
3. Date of
birth Jani9,1884
Place of birth
34
4.
Are you married, single or a widow?
S ingle
5. Have you any physical defects or tendency to constitutional or pulmonary trouble? not that I know of
Are you a citizen of the United States? yes
Are you physically strong and healthy? yes
6. Name educational institutions attended before entering training school, stating number of years at each and from which you
F
graduated Public school near is arren grow all Tenovelissn years
-
were
moody Bible Institute, Two years
0
7. What languages other than English do you speak?
S one german and Chinese.
S
8.
Occupation before entering training school siring at home
S
9.
From
what hospital training school did you receive your diploma? I llinois Training School
-
City and state
Chicago, Illinois
Date of graduation
1914
e
IO. Character of hospital: General? yes
II. Did your training include obstetrics? yes Care of men? yes Children? yes Contagious diseases? childrens Some,in Hockital.
Special? yes
Private? yes
I2. Daily average number of patients in hospital during training 17000018001 Length of course T hree years
13. Name and address of superintendent you
of training school under whom received training miss Helen Scott Hay,
,
Dept. of hursing, RedCrose, Mrs. Simpson, (Gddress unknown miss many C. Wheler bicagoll St
14.
If your training as a nurse was received in more than one hospital, give name, location and time spent in each. Chicago
Sying In Hospital, Chicago, Ill. 3 months. Passarant trepitial, Chicago, One month
15. Of what nursing organizations are you a member? alumne association of I T. S
nurses association of China
16.
Which, if any, is affiliated with the American Nurses Association? I llinois Training School
17. Give name and address of secretary of at least one of these organizations
18. Are you a registered nurse? year In what state? Illinois Date of registration. Feb. 4,1914 Number. 3605
miss Batty of C.d m Shanghai
19. How and where employed since graduation:
Give dates with months.
Name and address of employers:
seft America, may 14,
1994 for China Here
B rard of missions
been complayed in Minesion
work in the prince of Hena
of Crangelical The united church
since arrivalin china
Sec. Dr, B. H. nietel
Suft. of Sursep, Siling, Human
July, 1816.-
Penbrook, Pa
China
first time
Als.a
(Specify for which of the following services you wish to be considered.) Shanghan, intend
20. War service, wherever needed
after
When
available yes at present
Are you willing to take the oath of allegiance? yes
21. Instructor, Elementary Hygiene
22. Public Health Nursing
In Town and Country Nursing Service
or for War Service. afes
23.
Name and permanent address of nearest relative (Father) more Henry Hobein,
Barrington , Illinois, U. S, a
Date Seft.6, 1918.
Signature of Nurse. Coual F. Hobeine
To the Committee:
Application by Local forms Committee, (except of with a nurse credentials desiring (Forms to American enroll 3 and for Red 4), the together Cross, Washington, with Forms D. IO C. and II, should be forwarded to the the
This Town and Country Nursing Service) after approval and endorse- Chair-
blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, II, and A. R. C.
150.
ment
man, National Committee on Nursing Service,
Committee, case instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the
In the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to Local Local Com-
mittee, from whence credentials will be procured.
REQ.--17-2125B-20M-N
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"ocrText": "Chevron\nDMR1\nTHE AMERICAN RED CROSS\nI\nNURSING SERVICE\nApplication for Enrollment\ne.\n(To be filled out entirely in applicant's handwriting and each question answered fully)\nI. Name of applicant in full\nCora FlorRie Hobein\n2. Address in full, Street siling\nCity Hunani\nState. China\n0\n3. Date of\nbirth Jani9,1884\nPlace of birth\n34\n4.\nAre you married, single or a widow?\nS ingle\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble? not that I know of\nAre you a citizen of the United States? yes\nAre you physically strong and healthy? yes\n6. Name educational institutions attended before entering training school, stating number of years at each and from which you\nF\ngraduated Public school near is arren grow all Tenovelissn years\n-\nwere\nmoody Bible Institute, Two years\n0\n7. What languages other than English do you speak?\nS one german and Chinese.\nS\n8.\nOccupation before entering training school siring at home\nS\n9.\nFrom\nwhat hospital training school did you receive your diploma? I llinois Training School\n-\nCity and state\nChicago, Illinois\nDate of graduation\n1914\ne\nIO. Character of hospital: General? yes\nII. Did your training include obstetrics? yes Care of men? yes Children? yes Contagious diseases? childrens Some,in Hockital.\nSpecial? yes\nPrivate? yes\nI2. Daily average number of patients in hospital during training 17000018001 Length of course T hree years\n13. Name and address of superintendent you\nof training school under whom received training miss Helen Scott Hay,\n,\nDept. of hursing, RedCrose, Mrs. Simpson, (Gddress unknown miss many C. Wheler bicagoll St\n14.\nIf your training as a nurse was received in more than one hospital, give name, location and time spent in each. Chicago\nSying In Hospital, Chicago, Ill. 3 months. Passarant trepitial, Chicago, One month\n15. Of what nursing organizations are you a member? alumne association of I T. S\nnurses association of China\n16.\nWhich, if any, is affiliated with the American Nurses Association? I llinois Training School\n17. Give name and address of secretary of at least one of these organizations\n18. Are you a registered nurse? year In what state? Illinois Date of registration. Feb. 4,1914 Number. 3605\nmiss Batty of C.d m Shanghai\n19. How and where employed since graduation:\nGive dates with months.\nName and address of employers:\nseft America, may 14,\n1994 for China Here\nB rard of missions\nbeen complayed in Minesion\nwork in the prince of Hena\nof Crangelical The united church\nsince arrivalin china\nSec. Dr, B. H. nietel\nSuft. of Sursep, Siling, Human\nJuly, 1816.-\nPenbrook, Pa\nChina\nfirst time\nAls.a\n(Specify for which of the following services you wish to be considered.) Shanghan, intend\n20. War service, wherever needed\nafter\nWhen\navailable yes at present\nAre you willing to take the oath of allegiance? yes\n21. Instructor, Elementary Hygiene\n22. Public Health Nursing\nIn Town and Country Nursing Service\nor for War Service. afes\n23.\nName and permanent address of nearest relative (Father) more Henry Hobein,\nBarrington , Illinois, U. S, a\nDate Seft.6, 1918.\nSignature of Nurse. Coual F. Hobeine\nTo the Committee:\nApplication by Local forms Committee, (except of with a nurse credentials desiring (Forms to American enroll 3 and for Red 4), the together Cross, Washington, with Forms D. IO C. and II, should be forwarded to the the\nThis Town and Country Nursing Service) after approval and endorse- Chair-\nblank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, II, and A. R. C.\n150.\nment\nman, National Committee on Nursing Service,\nCommittee, case instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the\nIn the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to Local Local Com-\nmittee, from whence credentials will be procured.\nREQ.--17-2125B-20M-N"
}