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M
an
5
a
and D.C
e
Form 1045
Rev. Nov. 1942
+
(IMA wousa AMERICAN RED CROSS
zoa
NURSING SERVICE
manget
new york
If you have changed your last name since
F
contacting us. please check here.
Name in full manger (last) Feleni (first) DaBright (middle) Tel. No. mu. Dre/5-1884 2-8/00
e
=
If married, give maiden name
Date
of
birth
Marital status
Suige
Husband's name
c
Permanent address
132 (single, City
married, widowed, divorced)
new Yard
e
(street)
(city)
(county)
(state)
Probable address
some
for the next year
(street)
(city)
(county)
(state)
I
Give of relative or friend in United
Brother- name and (name) address Paue nearest marget (relationship) States: (address) Co. queenshrs n. Carolina
a
6
Are you employed in nursing at the present time?
Yes
No
o
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
F
Institutional
C
Public health
5
Industrial
Private duty
+
Other (write in)
Government Service:
Army, Regular
Navy, Regular
Veterans Administration
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?
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
or
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
none
In what major field was above study?
3. Training and experience in the public health field: Postgraduate 4 months or more
4
Certificate
Degree
Experience 6 months
Have you ever held a position as an air hostess?
Yes
No
Have you ever had any other air experience?
Yes
No
Specify
For
30
How long?
(OVER)
Page data
- Page
- 16
- Source index
- 0
- Type
- photo
- Media ID
- 95417004abc65256
- Size
- unknown
Document data
- ID
- 2661882
- 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": "M\nan\n5\na\nand D.C\ne\nForm 1045\nRev. Nov. 1942\n+\n(IMA wousa AMERICAN RED CROSS\nzoa\nNURSING SERVICE\nmanget\nnew york\nIf you have changed your last name since\nF\ncontacting us. please check here.\nName in full manger (last) Feleni (first) DaBright (middle) Tel. No. mu. Dre/5-1884 2-8/00\ne\n=\nIf married, give maiden name\nDate\nof\nbirth\nMarital status\nSuige\nHusband's name\nc\nPermanent address\n132 (single, City\nmarried, widowed, divorced)\nnew Yard\ne\n(street)\n(city)\n(county)\n(state)\nProbable address\nsome\nfor the next year\n(street)\n(city)\n(county)\n(state)\nI\nGive of relative or friend in United\nBrother- name and (name) address Paue nearest marget (relationship) States: (address) Co. queenshrs n. Carolina\na\n6\nAre you employed in nursing at the present time?\nYes\nNo\no\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nF\nInstitutional\nC\nPublic health\n5\nIndustrial\nPrivate duty\n+\nOther (write in)\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES\nAdministration\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?\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\nor\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\nnone\nIn what major field was above study?\n3. Training and experience in the public health field: Postgraduate 4 months or more\n4\nCertificate\nDegree\nExperience 6 months\nHave you ever held a position as an air hostess?\nYes\nNo\nHave you ever had any other air experience?\nYes\nNo\nSpecify\nFor\n30\nHow long?\n(OVER)"
}