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D
Form 1045
Rev. Nov. 1941
-
AMERICAN RED CROSS
NURSING SERVICE
state
Name in full Doggett Elizabeth (first) Amustrong (middle) Tel. No. 2448 College
(last)
If married, give maiden name Elizabth Creelman
Year of birth Warch 15th 1888
Husband's Leorard a. Doggett
Marital status
name
(single, married, widowed, divorced)
address 357 E. Prespect au state College
Pa
Permanent
(street)
(city)
(county)
(state)
Louth
Mr
Probable address
5
for the next year
same
(street)
(city)
(county)
(state)
E
Give name and address of nearest relative or friend in United States:
A
Leonard a. Doggett Husband (relationship)
same
(name)
Are you employed in nursing at the present time? Yes
No
7 tm
=.
(address)
2
PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed
b
all
Institutional
attending
+1
Public health
eth
Industrial
one
5
Private duty
D
Other (write in)
O
Government Service: Army, Regular
Navy, Regular
Veterans Administration
Reserve
Children's Bureau
re
T
Reserve
C
U.S.P.H. Service
U.S. Indian Service
MAJOR RESPONSIBILITIES
Administration
Private duty
el
Teaching
-
L
of present employment
Supervision
General Staff
Other (specify)
How many years did you attend HIGH SCHOOL? One
Two
Three
Four
Graduated
D
Educated abroad High School Equirement
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
2. Have you taken any courses in a college or university?
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
12
In what major field was above study?
&
What languages, other than English, do you speak? None
3
* Academic year
(OVER)
Page data
- Page
- 13
- Source index
- 0
- Type
- photo
- Media ID
- 197d632fa986d5bc
- Size
- unknown
Document data
- ID
- 2661372
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Page context
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"ocrText": "D\nForm 1045\nRev. Nov. 1941\n-\nAMERICAN RED CROSS\nNURSING SERVICE\nstate\nName in full Doggett Elizabeth (first) Amustrong (middle) Tel. No. 2448 College\n(last)\nIf married, give maiden name Elizabth Creelman\nYear of birth Warch 15th 1888\nHusband's Leorard a. Doggett\nMarital status\nname\n(single, married, widowed, divorced)\naddress 357 E. Prespect au state College\nPa\nPermanent\n(street)\n(city)\n(county)\n(state)\nLouth\nMr\nProbable address\n5\nfor the next year\nsame\n(street)\n(city)\n(county)\n(state)\nE\nGive name and address of nearest relative or friend in United States:\nA\nLeonard a. Doggett Husband (relationship)\nsame\n(name)\nAre you employed in nursing at the present time? Yes\nNo\n7 tm\n=.\n(address)\n2\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nb\nall\nInstitutional\nattending\n+1\nPublic health\neth\nIndustrial\none\n5\nPrivate duty\nD\nOther (write in)\nO\nGovernment Service: Army, Regular\nNavy, Regular\nVeterans Administration\nReserve\nChildren's Bureau\nre\nT\nReserve\nC\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES\nAdministration\nPrivate duty\nel\nTeaching\n-\nL\nof present employment\nSupervision\nGeneral Staff\nOther (specify)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nD\nEducated abroad High School Equirement\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\n2. Have you taken any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\n*one year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\nPublic Health\n12\nIn what major field was above study?\n&\nWhat languages, other than English, do you speak? None\n3\n* Academic year\n(OVER)"
}