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    "label": "Kloman, Agnes Picket",
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    "id": "2661767",
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    "contentType": "document",
    "title": "Kloman, Agnes Picket",
    "citationUrl": "https://catalog.archives.gov/id/2661767",
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        "Records of the American National Red Cross",
        "Historical Nurse Files"
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    "coverageEndDate": {
        "day": 17,
        "logicalDate": "1948-03-17",
        "month": 3,
        "year": 1948
    },
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        "day": 17,
        "logicalDate": "1918-04-17",
        "month": 4,
        "year": 1918
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{
    "seq": 94,
    "pageIndex": 0,
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    "ocrText": "K\nA\n(p) Names of all relatives nearer than second cousins in the war service of the United States Government.\n5\nErasmus Helm, lst cousin\nrb\ns\n5. If foreign born, give date and court of your naturalization\n6. Single, married, widow, or widower\nSingle\n(a) Number of dependents\nNone\n(b) Full name and address of nearest relative or friend Mrs. (Andrew Davis, (sister)\nCharles St.Ave Station N. Baltimore, Md.\n(c) Full name of wife before marriage; or husband\n(d) Birthplace of wife or husband\n(e) Nationality of wife or husband\n$ Birthplace and nationality of father of wife or husband\n(g) Birthplace and nationality of mother of wife or husband\n7. Kind of service preferred. (Specify.) Public Health Nursing\n8. Would you enter foreign service? yes\n(a) If so, in what country or countries? Franceif desired\n(b) Describe fully any experience you have ever had in service of the American Red Cross.or any Foreign\nCountry\n9. Would you serve without pay and defray all of your necessary expenses?\nNo\n(a) With only expenses defrayed for you? No\n(b) If not, what minimum salary would you require in addition to the defraying of your expenses?\nWhat you consider right for a registered graduate nurse\nIO. What University or College attended? Columbia Univ. N.Y.\nYear graduated\n1905 from Hosp\n6 wks, gummer ourse\nII. Can you speak French fluently? No\n(a) If not, to what degree, if any? in Balto,\n(b) Can you translate French easily? No\n(c) If not, to what degree, if any? very little\nI2. What other foreign languages do you speak?\nNone\n(a) State extent of your knowledge of each\n13. As references, give names and addresses of three American citizens not related to you.\nMrs J.B. Britton, Warrenton Va.\nMiss ROberta Lee Ball, Union Protestant Infirmary, Balto, Md\nMra julian Keith, Warrenton, Va\n14.\nGive\nnames and addresses of all patriotic, beneficial, social or other form of clubs, societies or other organizations\nbased on race, nationality, etc., to which you belong or have at any time belonged, since August 1, 1914.\nNational Organization for Public Health Nursing\nMarkland State Association for Graduate Nurses\n15. If enrolled in service, name earliest date you could take up work June 15th 1918\nI hereby certify that the answers to the above questions are correct to the best of my knowledge and belief.\nAgnes-Pickett\nSignature.\nDivision Personnel Committee examining application\nDate of report\nReport of Committee. (Be specific.)\nl'ate of receipt at National Headquarters\nChecked by\nComments:"
}