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-
S
e
thief
1
D
5
+
01
-
DUESTIONAIRE
5
Date Dec 17-11
C.
e
Are you available for active service? no.
If not
available, give reasons Physical condition willnother
mit mV,
If not at present, give earliest date on which you could be
ready
Are you al'ready a member of al unit or a detachment? no
If so, which one ?
If needed, are you willing to act as an instructor in Elementary
Hygiene yes
and Home Care of the Sick?
Are member of a committee on Red Cross
you a Nursing Service? yes,
If so, which one ! Callas Tex, Sec. Celerancy serves
Name Antomethz Alilso her
Address 4011 Cole are
Badge Number 409
When filled in please return to
Bureau of Nursing,
American Red Cross
I
Washington, D. c.
-
S
+
;
f
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