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B
E
5
gudsi
Z
Form 1045
Rev. Nov. 1942
e
AMERICAN RED CROSS
ATET 81 TI.
xpa
NURSING SERVICE
munice
If you have changed your last name since
contacting us, please check here
Name in full Brown (last) Mellie (first)
Gates
Tel. No. Minnei 9961
(middle)
If married, give maiden name
Date of birth 7/12/1885
Marital status
single
Husband's name
a
(single, married, widowed, divorced)
Permanent address
Route 4
uncs
Delaware
Indiana
(street)
(city)
(county)
(state)
Probable address
for the
next year BAll memorial Hospital Muncie Belaware Inteana
(street)
(city)
(county)
(state)
Give name and address of nearest relative or friend in United States:
hanna (name) & Bream (relationship) Sister Route 4 (address) minue Indiana Phone 8098
Are you employed in nursing at the present time?
Yes
No
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
Institutional
Ball memmal Hospital minue Indiana
Public health
Industrial
Private duty
ai aldaliavá
Other (write in)
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)
If not employed, what type of nursing would you prefer to render?
How many years did you attend HIGH SCHOOL?
One
Two
Three
Four
Graduated
Yes
No
Before entering training, how many years did you attend COLLEGE?
Did you have a five-year course granting bachelor's degree?
AFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-
Postgraduate course
in a hospital
Experience in hospital
1. A postgraduate course or experience in any of the following services? (at least 3 months)
(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?
completed except fw these m Ed.
Less 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 major field was above study? Teaching m Schools of nursing
3. Training and experience in the public health field: Postgraduate 4 months or more
Certificate
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
a
(OVER)
Page data
- Page
- 13
- Source index
- 0
- Type
- photo
- Media ID
- 8776bac23a3f7e66
- Size
- unknown
Document data
- ID
- 2661165
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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Page context
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"ocrText": "B\nE\n5\ngudsi\nZ\nForm 1045\nRev. Nov. 1942\ne\nAMERICAN RED CROSS\nATET 81 TI.\nxpa\nNURSING SERVICE\nmunice\nIf you have changed your last name since\ncontacting us, please check here\nName in full Brown (last) Mellie (first)\nGates\nTel. No. Minnei 9961\n(middle)\nIf married, give maiden name\nDate of birth 7/12/1885\nMarital status\nsingle\nHusband's name\na\n(single, married, widowed, divorced)\nPermanent address\nRoute 4\nuncs\nDelaware\nIndiana\n(street)\n(city)\n(county)\n(state)\nProbable address\nfor the\nnext year BAll memorial Hospital Muncie Belaware Inteana\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nhanna (name) & Bream (relationship) Sister Route 4 (address) minue Indiana Phone 8098\nAre you employed in nursing at the present time?\nYes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nBall memmal Hospital minue Indiana\nPublic health\nIndustrial\nPrivate duty\nai aldaliavá\nOther (write in)\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES Administration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral staff\nOther (specify)\nIf not employed, what type of nursing would you prefer to render?\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nFour\nGraduated\nYes\nNo\nBefore entering training, how many years did you attend COLLEGE?\nDid you have a five-year course granting bachelor's degree?\nAFTER GRADUATION FROM YOUR SCHOOL OF NURSING, did you have-\nPostgraduate course\nin a hospital\nExperience in hospital\n1. A postgraduate course or experience in any of the following services? (at least 3 months)\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?\ncompleted except fw these m Ed.\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.D.\nM. D.\none academic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was above study? Teaching m Schools of nursing\n3. Training and experience in the public health field: Postgraduate 4 months or more\nCertificate\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\na\n(OVER)"
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