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N gut D.P. Form 1045 Rev. Nov. 1942 (IVA woras AMERICAN RED CROSS NURSING SERVICE newYnk If you have changed your last name since contacting us, please check here Name in full Nuno Christine Mercedes (middle) Tel. No. Phinelander 4 +i (last) (first) 6531 If married, give maiden name Date of birth aught 1892 5 Marital status single Husband's name e (single, married, widowed, divorced) Permanent address 215-873251 newyork newyork newyork (street) (city) (county) (state) Probable address for the next year Same (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: Jas. 7. nuno Brother manhasset L. ) (name) (relationship) (address) Are you employed in nursing at the present time? Yes H No special service PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Public health Industrial Private duty Other (write in) american Redcross Dursing Service not Hdg 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 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 dégree? 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) 4 Psychiatric nursing Operating room Anaesthesia W 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 w In what major field was above study? nursing 3. Training and experience in the public health field: Postgraduate 4 months or more to Certificate Degree Experience 6 months J 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 only Travel 2 (OVER) 1of 2

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    "ocrText": "N\ngut\nD.P.\nForm 1045\nRev. Nov. 1942\n(IVA\nworas\nAMERICAN RED CROSS\nNURSING SERVICE\nnewYnk\nIf you have changed your last name since\ncontacting us, please check here\nName\nin full Nuno Christine Mercedes (middle)\nTel. No. Phinelander 4\n+i\n(last)\n(first)\n6531\nIf married, give maiden name\nDate of birth aught 1892\n5\nMarital status\nsingle\nHusband's name\ne\n(single, married, widowed, divorced)\nPermanent\naddress 215-873251 newyork\nnewyork\nnewyork\n(street)\n(city)\n(county)\n(state)\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:\nJas. 7. nuno\nBrother\nmanhasset L. )\n(name)\n(relationship)\n(address)\nAre you employed in nursing at the present time?\nYes\nH\nNo\nspecial service\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nIndustrial\nPrivate duty\nOther (write in)\namerican Redcross Dursing Service not Hdg\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\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 dégree?\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)\n4\nPsychiatric nursing\nOperating room\nAnaesthesia\nW\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\nw\nIn what major field was above study? nursing\n3. Training and experience in the public health field: Postgraduate 4 months or more\nto\nCertificate\nDegree\nExperience 6 months\nJ\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 only Travel\n2\n(OVER)\n1of\n2"
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