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Form 1045 AMERICAN RED CROSS Rev. Nov. 1942 AIT BITI zos NURSING SERVICE no Menneast Co. M If you have changed your last name since Name in full Johnson contacting us, please check here mabel nelson Tel. No main 6428 (last) (first) (middle) If married, give maiden name mabei nelson Date of birth may 25-1891 absel M Marital status. married Husband's name W. ashton Johnson (single, married, widowed, divorced) Permanent address 2011 quilford Road Rockford Winnebago Illinois (s) (street) Probable address (city) (county) (state) for the next year 2011 quilford (street) Road, Rockford Winnebago Illinois (city) (county) (state) I M Give name and address of nearest relative or friend in United States: Jea W. ashton Johnson husband 2011 quilford Road, Rockford, Illinois beli a (name) - (relationship) (address) Are you employed in nursing at the present time? Yes No S. 5 PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed on (D - Institutional Public health Industrial L Private duty Other (write in) Government Service: Army, Regular Navy, Regular Veterans Administration C Reserve Reserve Children's Bureau U.S.P.H. Service U.S. Indian Service MAJOR RESPONSIBILITIES Administration 201 Teaching of present employment Private duty Supervision Jon General staff Other (specify) If not employed, what type of nursing would you prefer to render? Public Health How many years did you attend HIGH SCHOOL? One Two Three Four Graduated x Yes No Before entering training, how many years did you attend COLLEGE? none Did you have a five-year course granting bachelor's degree? AFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have- Postgraduate course 1. A postgraduate course or experience in any of the following services? (at in a hospital Experience in hospital least 3 months) (at least 6 months) Communicable disease nursing (include tuberculosis) Psychiatric nursing Operating room nCI Anaesthesia 2. Have you had any courses in a college or university? Less than One Two Three Four Bachelor's Master's Ph.D. one academic year M. D. year years years years degree degree degree degree bok In what major field was above study? English - Govern ment. 3. Training and experience in the public health field: Postgraduate 4 months or more Certificate Degree Experience-6-monthe- byears Have you ever held a position as an air hostess? Yes No How long? 6 Have you ever had any other air experience? Yes No Specify of Over sea's service with the American Red Cross in (OVER) France and montenegro 10-16-43

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ID
2661711
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Type
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DTO data
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Context sent to Scholar

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Page context
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    "ocrText": "Form 1045\nAMERICAN RED CROSS\nRev. Nov. 1942\nAIT\nBITI\nzos NURSING SERVICE\nno\nMenneast Co.\nM\nIf you have changed your last name since\nName in full Johnson\ncontacting us, please check here\nmabel\nnelson\nTel. No main 6428\n(last)\n(first)\n(middle)\nIf married, give maiden name mabei nelson\nDate of birth may 25-1891\nabsel\nM\nMarital status.\nmarried\nHusband's name W. ashton Johnson\n(single, married, widowed, divorced)\nPermanent address 2011 quilford Road Rockford Winnebago\nIllinois\n(s)\n(street)\nProbable\naddress\n(city)\n(county)\n(state)\nfor the next year 2011 quilford (street) Road, Rockford Winnebago Illinois\n(city)\n(county)\n(state)\nI\nM\nGive name and address of nearest relative or friend in United States:\nJea\nW. ashton Johnson\nhusband 2011 quilford Road, Rockford, Illinois\nbeli\na\n(name)\n-\n(relationship)\n(address)\nAre you employed in nursing at the present time?\nYes\nNo\nS.\n5\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\non\n(D\n-\nInstitutional\nPublic health\nIndustrial\nL\nPrivate duty\nOther (write in)\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nC\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES\nAdministration\n201\nTeaching\nof present employment\nPrivate duty\nSupervision\nJon\nGeneral staff\nOther (specify)\nIf not employed, what type of nursing would you prefer to render?\nPublic\nHealth\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nFour\nGraduated\nx\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE? none\nDid you have a five-year course granting bachelor's degree?\nAFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-\nPostgraduate course\n1. A postgraduate course or experience in any of the following services? (at\nin a hospital\nExperience in hospital\nleast\n3\nmonths)\n(at least 6 months)\nCommunicable disease nursing (include tuberculosis)\nPsychiatric nursing\nOperating room\nnCI\nAnaesthesia\n2. Have you had any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\none academic year\nM. D.\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nbok\nIn\nwhat major field was above study? English - Govern ment.\n3. Training and experience in the public health field: Postgraduate 4 months or more\nCertificate\nDegree\nExperience-6-monthe-\nbyears\nHave you ever held a position as an air hostess?\nYes\nNo\nHow long?\n6\nHave you ever had any other air experience?\nYes\nNo\nSpecify\nof\nOver sea's service with the American Red Cross in\n(OVER)\nFrance and montenegro\n10-16-43"
}