Ask the Scholar
Page 4 of 88
I can add historical knowledge about this page.
Page image
OCR
Form 1037
Rev. May, 1939
THE AMERICAN RED CROSS NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out in applicant's handwriting and each question answered fully)
1. Name of applicant in full m arie - Teckla Raykawekin
Date of birth aug (Day) 1912 (Year)
(Month)
If married, give maiden name
2. Permanent address 303 8.10th
(Street)
Spoksner (City) Washington (State)
Probable address for one year
303. & 10th. (Street) Spokane (City) Washington
3. Race White
(State)
Place of birth Bluffton, Minnesota Marital status Single
(single, married, widowed or divorced)
Birthplace of father of Germany the United
Mother Minnesata Citizenship of father. yrs
Are you a citizen States?
yes
4. GENERAL EDUCATION (prior to entering nursing) :
No. of years
Did you graduate?
attendance
Yes or No
High School
4
Normal school
ges
College or University
Other
What languages other than English do you speak? German
(Underline those which you speak fluently)
5. PROFESSIONAL EDUCATION:
a. School of Nursing from which you graduated :
St. Gabriel's School (Name) of nursing
Little Falls minnesota
(City)
(State)
Date of graduation Sept. 8 1934
Length of course
3 years
Character of hospital : General or special General
Daily Average
No. of patients
during training
}
2/
In this hospital, which services did you receive experience in as segregated services (underline) :
Eye, Ear Communicable
Outpatient
Medicine-Surgery-Pediatrics-Obstetrics-Nose & Throat-Diseases-Psychiatry- - Department
In this hospital, which services did you receive experience in as non-segregated services ( underline) :
Eye, Ear Communicable
Outpatient
Medicine-Surgery-Pediatrics-Obstetrics-Nose & Throat--Diseases-Psychiatry- - - Department
b. Undergraduate affiliations :
Clinical
Hospital or Organization
City and State
specialty
No. months
(2) (1) St. mary School of nursing. Duluth Minnesata Tuberculosis Pediatrictric
2 14 mo.
mo
(3)
Diet Lab
Surgery
42 days 1 mo
c. Postgraduate clinical or field courses (Do not include academic work).
Clinical
Hospital or Organization
City and State
specialty
No. months
(1)
(2)
(3)
d. Academic study since graduation from Nursing School.
City and State
Nature of work
No. months
College or University
(1)
(2)
(3)
(OVER)
Page data
- Page
- 4
- Source index
- 0
- Type
- photo
- Media ID
- 021106b67deef010
- Size
- unknown
Document data
- ID
- 2662170
- Core
- doc
- Type
- document
DTO data
{
"id": "2662170",
"sourceUrl": "https://catalog.archives.gov/id/2662170",
"contentType": "document",
"title": "Rietzke, Mrs. Marie T. nee Marie Teckla Raykowski",
"citationUrl": "https://catalog.archives.gov/id/2662170",
"collections": [
"Records of the American National Red Cross",
"Historical Nurse Files"
],
"iiifBase": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_649063_0475/40033_649063_0475-00278.tif",
"thumbnailUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_649063_0475/40033_649063_0475-00278.tif",
"largeImageUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_649063_0475/40033_649063_0475-00278.tif",
"imageCount": 88,
"hasImages": true,
"source": "import",
"hasTranscription": false
}
Context sent to Scholar
Document identity
{
"localId": "2662170",
"label": "Rietzke, Mrs. Marie T. nee Marie Teckla Raykowski",
"core": "doc",
"dtoType": "document",
"citationUrl": "https://catalog.archives.gov/id/2662170"
}
Document source metadata
{
"id": "2662170",
"sourceUrl": "https://catalog.archives.gov/id/2662170",
"contentType": "document",
"title": "Rietzke, Mrs. Marie T. nee Marie Teckla Raykowski",
"citationUrl": "https://catalog.archives.gov/id/2662170",
"collections": [
"Records of the American National Red Cross",
"Historical Nurse Files"
],
"iiifBase": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_649063_0475/40033_649063_0475-00278.tif",
"thumbnailUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_649063_0475/40033_649063_0475-00278.tif",
"largeImageUrl": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_649063_0475/40033_649063_0475-00278.tif",
"imageCount": 88,
"hasImages": true,
"source": "import",
"hasTranscription": false
}
Document source extras
{
"url": "https://catalog.archives.gov/id/2662170",
"naId": 2662170,
"coverageEndDate": {
"day": 15,
"logicalDate": "1957-02-15",
"month": 2,
"year": 1957
},
"coverageStartDate": {
"day": 8,
"logicalDate": "1941-09-08",
"month": 9,
"year": 1941
},
"levelOfDescription": "fileUnit",
"onlineResources": [
{
"description": "Ancestry Collection: 2365",
"note": "This file was scanned as part of a collaboration effort between Ancestry and the National Archives.",
"url": "https://www.ancestryinstitution.com/search/collections/2365/"
}
],
"recordType": "description",
"ocrSource": "nara-archive"
}
Page context
{
"seq": 4,
"pageIndex": 0,
"type": "photo",
"url": "https://s3.us-east-1.amazonaws.com/NARAprodstorage/lz/partners/dc-metro/anrc/649203/40033_649063_0475/40033_649063_0475-00281.tif",
"mediaId": "021106b67deef010",
"ocrText": "Form 1037\nRev. May, 1939\nTHE AMERICAN RED CROSS NURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out in applicant's handwriting and each question answered fully)\n1. Name of applicant in full m arie - Teckla Raykawekin\nDate of birth aug (Day) 1912 (Year)\n(Month)\nIf married, give maiden name\n2. Permanent address 303 8.10th\n(Street)\nSpoksner (City) Washington (State)\nProbable address for one year\n303. & 10th. (Street) Spokane (City) Washington\n3. Race White\n(State)\nPlace of birth Bluffton, Minnesota Marital status Single\n(single, married, widowed or divorced)\nBirthplace of father of Germany the United\nMother Minnesata Citizenship of father. yrs\nAre you a citizen States?\nyes\n4. GENERAL EDUCATION (prior to entering nursing) :\nNo. of years\nDid you graduate?\nattendance\nYes or No\nHigh School\n4\nNormal school\nges\nCollege or University\nOther\nWhat languages other than English do you speak? German\n(Underline those which you speak fluently)\n5. PROFESSIONAL EDUCATION:\na. School of Nursing from which you graduated :\nSt. Gabriel's School (Name) of nursing\nLittle Falls minnesota\n(City)\n(State)\nDate of graduation Sept. 8 1934\nLength of course\n3 years\nCharacter of hospital : General or special General\nDaily Average\nNo. of patients\nduring training\n}\n2/\nIn this hospital, which services did you receive experience in as segregated services (underline) :\nEye, Ear Communicable\nOutpatient\nMedicine-Surgery-Pediatrics-Obstetrics-Nose & Throat-Diseases-Psychiatry- - Department\nIn this hospital, which services did you receive experience in as non-segregated services ( underline) :\nEye, Ear Communicable\nOutpatient\nMedicine-Surgery-Pediatrics-Obstetrics-Nose & Throat--Diseases-Psychiatry- - - Department\nb. Undergraduate affiliations :\nClinical\nHospital or Organization\nCity and State\nspecialty\nNo. months\n(2) (1) St. mary School of nursing. Duluth Minnesata Tuberculosis Pediatrictric\n2 14 mo.\nmo\n(3)\nDiet Lab\nSurgery\n42 days 1 mo\nc. Postgraduate clinical or field courses (Do not include academic work).\nClinical\nHospital or Organization\nCity and State\nspecialty\nNo. months\n(1)\n(2)\n(3)\nd. Academic study since graduation from Nursing School.\nCity and State\nNature of work\nNo. months\nCollege or University\n(1)\n(2)\n(3)\n(OVER)"
}