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Thomas,
APPLICATION BLANK
(This blank is to be filled out entirely in applicant's own handwriting. Enrolled Red Cross nurses need not answer questions
4 to 10 inclusive. Give badge number 4755 Gar
1.
Full name of applicant. SArAn margaret Thomas in CAR
{
(permanent) 315 niggrast EAu Claire Wisconsin
2. Address in full
(temporary)
3. Nationality American
Religious faith Protestant
5. Are you married, single or a widow ?
Marger
P
/4. Year of birth 1881
Place of birth EAUCIAIRE. Wis.
6. Occupation before entering training school College student
Baltimore From what hospital training school you graduated? Johns Hopkins
7. were
City and State md
1907
e
Date
8. Daily average number of patients in hospital during training 4th ? Length of course 3 yrs
t
9. Character of hospital: General?
Special?
Private?
10. Name and address of present superintendent of training school, or one under whom you received training
misshaulter (present)
miss G. C.Toss I Missnutting at time of Training.
11. Of what nursing organizations are you a member? EAu Claire Co grad. nurses Plasec.
Wisconsin Stale Assoc. J.H.H. Alumne
12. Give name and address of secretary of at least one of these organizations.
miss Bertha Schullz. State Secy
2nyself Secty. ofco. Society
13. Are you a registered nurse! yes In what State? Wisc.
Date of registration 1914(3)
14. Educational institutions attended before entering training school
Number
Date of
of years
graduation
Common schools
High school
Other educational institutions
I
15. Specify training in the following:
Where
Between what dates
Obstetrics
J.H.H.
1904-1
Pediatrics
-
Y Boston Floaling Hosp.
+
.
912(?)
Contagious nursing
Public Health Nursing :
Name and address
Ho Training
Where
Between what dates
of person in charge
Experience:
-
General visiting nursing
Infant welfare
Ladysmith Wise-
Jan-9 to Teb-20
mrs.J.w. CArow
LAdysmith
1915.
Wise-
Tuberculosis
School nursing
Industrial nursing
bast
Sanitary inspection
Other social work
The Woman's Club Y City put aside money to have anurse for 2mo. but I coundrolly
give them The 6 weeks They hope another year /õ 6 ° able to have one at /ear/- during
The School year
Grace 3-21-16
Page data
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- Source index
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- Type
- photo
- Media ID
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Document data
- ID
- 2662356
- Core
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- Type
- document
DTO data
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"ocrText": "Thomas,\nAPPLICATION BLANK\n(This blank is to be filled out entirely in applicant's own handwriting. Enrolled Red Cross nurses need not answer questions\n4 to 10 inclusive. Give badge number 4755 Gar\n1.\nFull name of applicant. SArAn margaret Thomas in CAR\n{\n(permanent) 315 niggrast EAu Claire Wisconsin\n2. Address in full\n(temporary)\n3. Nationality American\nReligious faith Protestant\n5. Are you married, single or a widow ?\nMarger\nP\n/4. Year of birth 1881\nPlace of birth EAUCIAIRE. Wis.\n6. Occupation before entering training school College student\nBaltimore From what hospital training school you graduated? Johns Hopkins\n7. were\nCity and State md\n1907\ne\nDate\n8. Daily average number of patients in hospital during training 4th ? Length of course 3 yrs\nt\n9. Character of hospital: General?\nSpecial?\nPrivate?\n10. Name and address of present superintendent of training school, or one under whom you received training\nmisshaulter (present)\nmiss G. C.Toss I Missnutting at time of Training.\n11. Of what nursing organizations are you a member? EAu Claire Co grad. nurses Plasec.\nWisconsin Stale Assoc. J.H.H. Alumne\n12. Give name and address of secretary of at least one of these organizations.\nmiss Bertha Schullz. State Secy\n2nyself Secty. ofco. Society\n13. Are you a registered nurse! yes In what State? Wisc.\nDate of registration 1914(3)\n14. Educational institutions attended before entering training school\nNumber\nDate of\nof years\ngraduation\nCommon schools\nHigh school\nOther educational institutions\nI\n15. Specify training in the following:\nWhere\nBetween what dates\nObstetrics\nJ.H.H.\n1904-1\nPediatrics\n-\nY Boston Floaling Hosp.\n+\n.\n912(?)\nContagious nursing\nPublic Health Nursing :\nName and address\nHo Training\nWhere\nBetween what dates\nof person in charge\nExperience:\n-\nGeneral visiting nursing\nInfant welfare\nLadysmith Wise-\nJan-9 to Teb-20\nmrs.J.w. CArow\nLAdysmith\n1915.\nWise-\nTuberculosis\nSchool nursing\nIndustrial nursing\nbast\nSanitary inspection\nOther social work\nThe Woman's Club Y City put aside money to have anurse for 2mo. but I coundrolly\ngive them The 6 weeks They hope another year /õ 6 ° able to have one at /ear/- during\nThe School year\nGrace 3-21-16"
}