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N Form 1045 Rev. Nov. 1941 you AMERICAN RED CROSS NURSING SERVICE Name in full Nuno ChrisTine mercedes Tel. No. Rh. 4 85.31 /last) (first) (middle) - If married, give maiden name Year of birth aught 1892 S - - Marital status Husband's name (single, married, widowed, divorced) Permanent address. 215 E. 134/11 newyork newyork (state) New york (street) (city) (county) Probable address for the next year 215-273-111- (city) n.y.C.ty (street) (county) (state) Give name and address of nearest relative or friend in United States: Florence m Johnson ( 7 nive) 215 27365 4nye (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) luurican RedCross hat tdag. 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) Consultant How many years did you attend HIGH SCHOOL? One Two Three Four Graduated 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 W Anaesthesia Public health nursing w 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 J In major field above study? P.H. huring what was 2 What languages, other than English, do you speak? (OVER) * Academic year 1of to 2

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        "month": 3,
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Page context
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    "ocrText": "N\nForm 1045\nRev. Nov. 1941\nyou\nAMERICAN RED CROSS\nNURSING SERVICE\nName in full\nNuno ChrisTine mercedes\nTel. No. Rh. 4 85.31\n/last)\n(first)\n(middle)\n-\nIf married, give maiden name\nYear of birth aught 1892\nS\n-\n-\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address. 215 E. 134/11 newyork newyork (state)\nNew york\n(street)\n(city)\n(county)\nProbable address\nfor the next year\n215-273-111-\n(city) n.y.C.ty\n(street)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\nFlorence m Johnson ( 7 nive)\n215 27365 4nye\n(name)\n(relationship)\n(address)\nAre you employed in nursing at the present time? Yes\nNo\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nIndustrial\nPrivate duty\n:\nOther (write in)\nluurican RedCross hat tdag.\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\n(specify) Consultant\nHow many years did you attend HIGH SCHOOL?\nOne\nTwo\nThree\nFour\nGraduated\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\nW\nAnaesthesia\nPublic health nursing\nw\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\nJ\nIn major field above study? P.H. huring\nwhat was\n2\nWhat languages, other than English, do you speak?\n(OVER)\n* Academic year\n1of\nto\n2"
}