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RECEIVED
Form 1045
4/15/12
Rev. Nov. 1941
AMERICAN RED CROSS
47551
NURSING SERVICE
Balerred to
Name in full
THOMAS
SARAH
MARGARET
Tel. No: TRINTDAD
(last)
(first)
(middle)
If married, give maiden name
Year of birth 1881
Marital status
Husband's name
(single, married, widowed, divorced)
Permanent address
1030 DUTTON AVE SAN LEANDRO -ALAMEDA - CALIFORNIA
(street)
(city)
(county)
(state)
Probable address
for the next year
(street)
(city)
(county)
(state)
t
Give name and address of nearest relative or friend in United States:
JAS. H THOMAS
-BROTHER
SAME
(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
Industrial
Private duty
Other (write in)
TEACHING 6 CLASSES J.N. HOME NURS.I.NG for ADULI ED. OAKLAND BOARD OF. EDUC..
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)
How many years did you attend HIGH SCHOOL? One
Two
Three
Four
Graduated
x
Yes
No
SINCE GRADUATION FROM YOUR SCHOOL OF NURSING
have you ever had-
1. A postgraduate course or experience in any of the following special services?
Postgraduate course
Experience in hospital
in a hospital
or public health field
(at least 3 months)
(at least 6 months)
Communicable disease nursing (include Tbc)
Psychiatric Nursing
Operating room
Anaesthesia
Public health nursing
6 MONTHS AT CHICAGO SCHOOL OF CIVICS
2. Have you taken any courses in a college or university
SUMMER CURSE AT COLUMBIA UNIV.
C
Less than
One
Two
Three
Four
Bachelor's
Master's
P.H.D.
Certificate in
one year
year
years
years
years
degree
degree
degree
Public Health
In what major field was above study?
PUBLIC HEALTH
What languages, other than English, do you speak? -0
* Academic year
(OVER)
4755
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- Type
- photo
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Document data
- ID
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- Core
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- Type
- document
DTO data
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"ocrText": "RECEIVED\nForm 1045\n4/15/12\nRev. Nov. 1941\nAMERICAN RED CROSS\n47551\nNURSING SERVICE\nBalerred to\nName in full\nTHOMAS\nSARAH\nMARGARET\nTel. No: TRINTDAD\n(last)\n(first)\n(middle)\nIf married, give maiden name\nYear of birth 1881\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address\n1030 DUTTON AVE SAN LEANDRO -ALAMEDA - CALIFORNIA\n(street)\n(city)\n(county)\n(state)\nProbable address\nfor the next year\n(street)\n(city)\n(county)\n(state)\nt\nGive name and address of nearest relative or friend in United States:\nJAS. H THOMAS\n-BROTHER\nSAME\n(name)\n(relationship)\n(address)\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\nTEACHING 6 CLASSES J.N. HOME NURS.I.NG for ADULI ED. OAKLAND BOARD OF. EDUC..\nGovernment Service: Army, 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)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nx\nYes\nNo\nSINCE GRADUATION FROM YOUR SCHOOL OF NURSING\nhave you ever had-\n1. A postgraduate course or experience in any of the following special services?\nPostgraduate course\nExperience in hospital\nin a hospital\nor public health field\n(at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include Tbc)\nPsychiatric Nursing\nOperating room\nAnaesthesia\nPublic health nursing\n6 MONTHS AT CHICAGO SCHOOL OF CIVICS\n2. Have you taken any courses in a college or university\nSUMMER CURSE AT COLUMBIA UNIV.\nC\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\none year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\nPublic Health\nIn what major field was above study?\nPUBLIC HEALTH\nWhat languages, other than English, do you speak? -0\n* Academic year\n(OVER)\n4755"
}