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Form 1045 Rev. Nov. 1942 AMERICAN RED CROSS NURSING SERVICE Indianspolic If you have changed your last name since contacting us, please check here Name in full TEAL. Helen. Tel. No. Market 5621 (last) (first) (middle) If married, give maiden name Date of birth 1889 Marital status Husband's name (single, married, widowed, divorced) Permanent address 734 (street) East mitchell Sr. Kendallinlle nober County- - Indiana (city) Probable address (county) (state) for the next year 1125 (street) Circle Town Bldg (city) Indianapilis. (county) Marion county (state) - Indiana Give name and address of nearest relative or friend in United States: mn. g. D. Brinkenhoff (name) (relationship) Harrison (address) Sv. garrett Indiana 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) Indiana State Nurses Association. 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) Executive secretary 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? 1yr. 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 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? Education and public health nursing 3. Training and experience 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? C Have you ever had any other air experience? Yes No Specify (OVER)

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2662347
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Context sent to Scholar

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Page context
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    "ocrText": "Form 1045\nRev. Nov. 1942\nAMERICAN RED CROSS\nNURSING SERVICE\nIndianspolic\nIf you have changed your last name since\ncontacting us, please check here\nName in full\nTEAL.\nHelen.\nTel. No. Market 5621\n(last)\n(first)\n(middle)\nIf married, give maiden name\nDate of birth 1889\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent\naddress 734 (street) East mitchell Sr. Kendallinlle nober County- - Indiana\n(city)\nProbable address\n(county)\n(state)\nfor the next year 1125 (street) Circle Town Bldg (city) Indianapilis. (county) Marion county (state) - Indiana\nGive name and address of nearest relative or friend in United States:\nmn. g. D. Brinkenhoff (name) (relationship) Harrison (address) Sv. garrett Indiana\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)\nIndiana State Nurses Association.\nGovernment Service: Army, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S.\nIndian\nService\nMAJOR RESPONSIBILITIES\nAdministration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral staff\nOther (specify) Executive secretary\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\nentering\ntraining,\nhow\nmany\nyears\ndid\nyou\nattend\nCOLLEGE?\n1yr.\nDid\nyou\nhave\na\nfive-year\ncourse\ngranting\nbachelor's\ndegree?\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\nwhat\nmajor\nfield\nwas\nabove\nstudy?\nEducation\nand\npublic\nhealth\nnursing\n3. Training and experience 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?\nC\nHave you ever had any other air experience?\nYes\nNo\nSpecify\n(OVER)"
}