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M
al
D
5
Confidential,
5
PERSONAL INC/ORMITION shiet (To be filled out in triplicate) Palestine
To the Secretary and Treasurer, Red Cross Commission to
L
1. Full name Cunce Sevo malley
0
Complete home address 5917 whitney Street, Dahland California
a
2.
-
3. Date and place of birth Dec.14, 1875 Clinton, man -
is
e
4.
Nationality (if foreign born
date and place of naturalization
5.
Name of father Custin J Omally - (Jeseph)
6.
Name of mother Elizabeth Clune Omally
7.
Date and place of birth of fother Dec. 25, 1852 , Clinton
8. Dote and place of birth of mother Feb.12, 1852 , Workster, nian
9. of graduction llinton High School June 1893
Flaco and datos to brester City Hospitallting 1905
10. Titlo und dograd if any
11. Brigf Statemont of oxporienco laught in man Public Schools 8yr
Supering Hospitax nurse st. Suhes manila 7 months
Private nursing in homes an a hospitals in manilaps . 4 yr-
Private nursing w crester, man 6 years
12.
Whit languigos spokon Englial.
Official connection with Commiscion Public Nialle Aures Palestinolent
13.
14.
Amount of compensation (monthly) und $ 60.00
cllowance, if any. Board , Some clothing equipment
15.
In the event it is desirod any part of your compensition to be
peid to, any porson in Amorica so giving full nemo and
address.
$ 20,00 a mo.
Austin J. D malley 5917 whitney st
Caleland California
16.
Numbor md deccription of pigcos of bessags 1 suitcase
I stramer trunk 36 in. long of I hol d all
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"ocrText": "0\nM\nal\nD\n5\nConfidential,\n5\nPERSONAL INC/ORMITION shiet (To be filled out in triplicate) Palestine\nTo the Secretary and Treasurer, Red Cross Commission to\nL\n1. Full name Cunce Sevo malley\n0\nComplete home address 5917 whitney Street, Dahland California\na\n2.\n-\n3. Date and place of birth Dec.14, 1875 Clinton, man -\nis\ne\n4.\nNationality (if foreign born\ndate and place of naturalization\n5.\nName of father Custin J Omally - (Jeseph)\n6.\nName of mother Elizabeth Clune Omally\n7.\nDate and place of birth of fother Dec. 25, 1852 , Clinton\n8. Dote and place of birth of mother Feb.12, 1852 , Workster, nian\n9. of graduction llinton High School June 1893\nFlaco and datos to brester City Hospitallting 1905\n10. Titlo und dograd if any\n11. Brigf Statemont of oxporienco laught in man Public Schools 8yr\nSupering Hospitax nurse st. Suhes manila 7 months\nPrivate nursing in homes an a hospitals in manilaps . 4 yr-\nPrivate nursing w crester, man 6 years\n12.\nWhit languigos spokon Englial.\nOfficial connection with Commiscion Public Nialle Aures Palestinolent\n13.\n14.\nAmount of compensation (monthly) und $ 60.00\ncllowance, if any. Board , Some clothing equipment\n15.\nIn the event it is desirod any part of your compensition to be\npeid to, any porson in Amorica so giving full nemo and\naddress.\n$ 20,00 a mo.\nAustin J. D malley 5917 whitney st\nCaleland California\n16.\nNumbor md deccription of pigcos of bessags 1 suitcase\nI stramer trunk 36 in. long of I hol d all"
}