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Form 1045 AMERICAN RED CROSS NURSING SERVICE gid DC B new york Rev. Nov. 1942 If you have changed your last name since contacting us, please check here Name in full JacobseN Marguerite K. Tel. No. Columbus 5-8244 (last) (first) (middle) If married, give maiden name Date of birth 3/5/96 Marital status SiNgle Husband's name (single, married, widowed, divorced) Permanent address 22 chestNut GirdTd Eric Penn. (street) (city) (county) (state) Probable address for the next year 350 W 155th New York N.Y. N.Y. (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: mis J. JacobseN (Mother) 27 chestnut St. Girerd Pa. (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) Executive work in nursing organization 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? none Did you have a five-year course granting bachelor's degree? no 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? 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? Supervision Public Health 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 (OVER)

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84
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0
Type
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Media ID
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Size
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2661692
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Context sent to Scholar

Document identity
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Document source extras
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    "coverageEndDate": {
        "day": 5,
        "logicalDate": "1945-09-05",
        "month": 9,
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Page context
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    "ocrText": "Form 1045\nAMERICAN RED CROSS\nNURSING SERVICE\ngid DC B new york Rev. Nov. 1942\nIf you have changed your last name since\ncontacting us, please check here\nName\nin\nfull\nJacobseN\nMarguerite K.\nTel. No. Columbus 5-8244\n(last)\n(first)\n(middle)\nIf married, give maiden name\nDate of birth 3/5/96\nMarital status\nSiNgle\nHusband's name\n(single, married, widowed, divorced)\nPermanent address\n22 chestNut GirdTd\nEric\nPenn.\n(street)\n(city)\n(county)\n(state)\nProbable address\nfor the next year\n350 W 155th\nNew York\nN.Y.\nN.Y.\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nmis J. JacobseN (Mother) 27 chestnut St. Girerd Pa.\n(name)\n(relationship)\n(address)\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)\nExecutive work in nursing organization\nGovernment Service:\nArmy, 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)\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? none\nDid you have a five-year course granting bachelor's degree?\nno\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?\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? Supervision Public Health 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\n(OVER)"
}