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Form 1045
S
Rev. Nov. 1942
AMERICAN RED CROSS
Central
NURSING SERVICE
2 RE,
Bugen
If you have changed your last name since
contacting
us,
please
check
here.
Name in full
S-mythe (last) Era (first) Louise (middle)
Tel. No. Hack 2-6096W
-
If married, give maiden name
Date of birth may 30-1878
Marital status
Husband's name
Passave (street) St. Harkinsack (city) (county) Bergen rent Jersey (state)
(single, married, widowed, divorced)
Permanent address
Probable address
for the next year
above
(street)
(city)
(county)
(state)
Give
name
his
grace address of nearest millar relative or friend friend in United States: 40 Passaic Hacksmack n.J
and
(name)
(relationship)
(address)
Are you employed in nursing at the present time?
Yes
No
PRESENT
EMPLOYMENT
(check
below)
Name
of
agency
or
institution
with
which
employed
Institutional
Public
health
Bursan maternald bhild Health St. Dept. Health Hanton hit
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.
MAJOR RESPONSIBILITIES
Administration
Private duty
of present employment
Supervision
staff
Other (specify)
If
not
employed,
what
type
of
nursing
prefer
render?
How
years
did
you
attend
HIGH
SCHOOL?
One
Two
h
Three
Four
Graduated
Yes
No
Before entering training, years did you attend COLLEGE? -
Did
you
have
a
five-year
bachelor's
degree?
m
AFTER
GRADUATION
FROM
YOUR
SCHOOL
OF
NURSING,
did
you
have-
Postgraduate course
in a hospital
Experience
in
1. A postgraduate course or experience in any of the following services? (at least 3 months)
hospital
(at least 6 months)
Communicable disease nursing (include tuberculosis)
Psychiatric nursing
Operating room
Anaesthesia
2. Have you had any courses in a college or university?
than
One
Two
Three
Four
Bachelor's
Master's
Ph.D.
M.
D.
one
academic
year
year
years
years
years
degree
degree
degree
degree
In
what
was
above
study?
Public
Herallte
3.
the
public
health
field:
Postgraduate
4
months
or
more
Degree
Experience 6 months
Have you ever held a position as an air hostess?
Yes
No
How long?
Have you ever had any other air experience?
Yes
No
Specify
(OVER)
Page data
- Page
- 12
- Source index
- 0
- Type
- photo
- Media ID
- a12edb3ee99b5bb3
- Size
- unknown
Document data
- ID
- 2662280
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source extras
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"coverageEndDate": {
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"logicalDate": "1945-09-05",
"month": 9,
"year": 1945
},
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"day": 10,
"logicalDate": "1919-03-10",
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Page context
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"ocrText": "Form 1045\nS\nRev. Nov. 1942\nAMERICAN RED CROSS\nCentral\nNURSING SERVICE\n2 RE,\nBugen\nIf you have changed your last name since\ncontacting\nus,\nplease\ncheck\nhere.\nName in full\nS-mythe (last) Era (first) Louise (middle)\nTel. No. Hack 2-6096W\n-\nIf married, give maiden name\nDate of birth may 30-1878\nMarital status\nHusband's name\nPassave (street) St. Harkinsack (city) (county) Bergen rent Jersey (state)\n(single, married, widowed, divorced)\nPermanent address\nProbable address\nfor the next year\nabove\n(street)\n(city)\n(county)\n(state)\nGive\nname\nhis\ngrace address of nearest millar relative or friend friend in United States: 40 Passaic Hacksmack n.J\nand\n(name)\n(relationship)\n(address)\nAre you employed in nursing at the present time?\nYes\nNo\nPRESENT\nEMPLOYMENT\n(check\nbelow)\nName\nof\nagency\nor\ninstitution\nwith\nwhich\nemployed\nInstitutional\nPublic\nhealth\nBursan maternald bhild Health St. Dept. Health Hanton hit\nIndustrial\nPrivate\nduty\nOther\n(write\nin)\nGovernment Service: Army, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H.\nService\nU.S.\nMAJOR RESPONSIBILITIES\nAdministration\nPrivate duty\nof present employment\nSupervision\nstaff\nOther (specify)\nIf\nnot\nemployed,\nwhat\ntype\nof\nnursing\nprefer\nrender?\nHow\nyears\ndid\nyou\nattend\nHIGH\nSCHOOL?\nOne\nTwo\nh\nThree\nFour\nGraduated\nYes\nNo\nBefore entering training, years did you attend COLLEGE? -\nDid\nyou\nhave\na\nfive-year\nbachelor's\ndegree?\nm\nAFTER\nGRADUATION\nFROM\nYOUR\nSCHOOL\nOF\nNURSING,\ndid\nyou\nhave-\nPostgraduate course\nin a hospital\nExperience\nin\n1. A postgraduate course or experience in any of the following services? (at least 3 months)\nhospital\n(at least 6 months)\nCommunicable disease nursing (include tuberculosis)\nPsychiatric nursing\nOperating room\nAnaesthesia\n2. Have you had any courses in a college or university?\nthan\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\nM.\nD.\none\nacademic\nyear\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn\nwhat\nwas\nabove\nstudy?\nPublic\nHerallte\n3.\nthe\npublic\nhealth\nfield:\nPostgraduate\n4\nmonths\nor\nmore\nDegree\nExperience 6 months\nHave you ever held a position as an air hostess?\nYes\nNo\nHow long?\nHave you ever had any other air experience?\nYes\nNo\nSpecify\n(OVER)"
}