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Form 1045
Rev. Nov. 1942
CVVA wossa AMERICAN RED CROSS
NURSING SERVICE
N'
chicago
If you have changed your last name since
Name in full persive (last) Hoagland (first) (middle)
contacting us, please check here
Tel. No. Ind 2683
If married, give maiden name
Single
Date of birth June 12, 1884
Marital status
Husband's name
Permanent address 4212 (single, (street) n married, Learritt divorced) (city) chicago (county) Cook (state) delo
widowed,
Probable address
for the next year
same
(street)
(city)
(county)
(state)
Give name and address of nearest relative or friend in United States:
PRHongland (name) (relationship) Brother 4212 n Learritts (address) chicago all
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)
anisthetist
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.
Anaesthesia Geven anithetics 27 yes at Cooke Hopp, Chicago
Operating room charge of Closeling Rooms 2 yrs at Glemelle Herp-Cleveloughd
2. Have you had any courses in a college or university?
Less than
One
Two
Three
Four
Bachelor's
Master's
Ph.I
M. D.
one academic year
year
years
years
years
degree
degree
degree
degree
In what major field was above study?
3. Training and experience in the public health field: Postgraduate 4 months or more
to
Certificate
Degree
Experience 6 months
3
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
e
15 marths over seas desire with the Red (OVER) Class
during 1st World. was
Page data
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- 77
- Source index
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- Type
- photo
- Media ID
- 88690be31e1a4f0f
- Size
- unknown
Document data
- ID
- 2661647
- 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": "and\nForm 1045\nRev. Nov. 1942\nCVVA wossa AMERICAN RED CROSS\nNURSING SERVICE\nN'\nchicago\nIf you have changed your last name since\nName in full persive (last) Hoagland (first) (middle)\ncontacting us, please check here\nTel. No. Ind 2683\nIf married, give maiden name\nSingle\nDate of birth June 12, 1884\nMarital status\nHusband's name\nPermanent address 4212 (single, (street) n married, Learritt divorced) (city) chicago (county) Cook (state) delo\nwidowed,\nProbable address\nfor the next year\nsame\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nPRHongland (name) (relationship) Brother 4212 n Learritts (address) chicago all\nAre you employed in nursing at the present time?\nYes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\nanisthetist\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.\nAnaesthesia Geven anithetics 27 yes at Cooke Hopp, Chicago\nOperating room charge of Closeling Rooms 2 yrs at Glemelle Herp-Cleveloughd\n2. Have you had any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nPh.I\nM. D.\none academic year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\ndegree\nIn what major field was above study?\n3. Training and experience in the public health field: Postgraduate 4 months or more\nto\nCertificate\nDegree\nExperience 6 months\n3\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\ne\n15 marths over seas desire with the Red (OVER) Class\nduring 1st World. was"
}