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Z 3 etc. e 1 C e a s. I S F. a rb a at a 1 5 I - Not Employed Date Reserve Present Employment (Experience) Available - J. I 2 I PH PD o Name of Agency I PH PD o Yes No H.N. 1943 x GD Peekskill Hosp. 1944 " 10-22-18 Assigned 6-25- 19 Released A.R. c. Date Probable address for the year Telephone No. 1144 no guest *Key: I-Institutional PH-Public Health D-Private Duty O-Other H. N.-Home Nursing (check if interested) Indicate major responsibility in "Institutional" and "Public_Health" columns according to following key: Ad. -Administration Sup.-Supervision ns.-Instruction He. N -Head Nurse GS-General Staff

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