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A
Division PACIFIC
Questionnaire
Date April 2x, 1922
33
1. Name (mr.) Ursula Tibbel Over the
2. Address - Femporary.
Permanent. 6008 - 8th Ave N.E. Seattle, Wash
3. Red Cross Badge Number.
19511
4. Date of appointment to service. august 1918
5. Date of discharge from service. April
1920
6. Service with - Army Evac Hosp. Toul. France Bast 82, Toul
Red Navy. Cross. Kavadar Serbica, Feel 1/9 - Jan'20
U. S. Public Health Service, Sanitary Zone.
Emergency, Influenza, Epidemic, Disaster, etc.
S
1,
Condition of health on discharge. Fainly good
8. Condition of health at present time.
i
1,
9. Approximate date of illness if any and where.
10.Have you notified the Vet. Bureau, or the Red Cross Nursing Service?
11 ,Are you drawing-compensation from the Vet. Bureau?
Date granted.
No
Number.
Hospitalization if any.
Name and address of doctor by whom examined,
)
1922
12.Rewarks:
13.Vocational Training.
Number
Where.
What kind.
Length of Course.
It.Remarks:
15 AAr you drawing Insurance from the American Red Cross?
no
Date granted.
5
16 .Present occupation.
Housewife
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"ocrText": "A\nDivision PACIFIC\nQuestionnaire\nDate April 2x, 1922\n33\n1. Name (mr.) Ursula Tibbel Over the\n2. Address - Femporary.\nPermanent. 6008 - 8th Ave N.E. Seattle, Wash\n3. Red Cross Badge Number.\n19511\n4. Date of appointment to service. august 1918\n5. Date of discharge from service. April\n1920\n6. Service with - Army Evac Hosp. Toul. France Bast 82, Toul\nRed Navy. Cross. Kavadar Serbica, Feel 1/9 - Jan'20\nU. S. Public Health Service, Sanitary Zone.\nEmergency, Influenza, Epidemic, Disaster, etc.\nS\n1,\nCondition of health on discharge. Fainly good\n8. Condition of health at present time.\ni\n1,\n9. Approximate date of illness if any and where.\n10.Have you notified the Vet. Bureau, or the Red Cross Nursing Service?\n11 ,Are you drawing-compensation from the Vet. Bureau?\nDate granted.\nNo\nNumber.\nHospitalization if any.\nName and address of doctor by whom examined,\n)\n1922\n12.Rewarks:\n13.Vocational Training.\nNumber\nWhere.\nWhat kind.\nLength of Course.\nIt.Remarks:\n15 AAr you drawing Insurance from the American Red Cross?\nno\nDate granted.\n5\n16 .Present occupation.\nHousewife"
}