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FORM 1045 REV. JAN 1941 AMERICAN RED CROSS NATIONAL HEADQUARTERS WASHINGTON, D.C. Name in full Beauchamp, (SURNAME) LINNIE (FIRST) Year of Birth 1892 (MIDDLE) Husband's name - Permanent address 2106 North Van Buren st Pulas/91 ANKansas (STREET) (CITY) (COUNTY) (STATE) Probable address for the next year Havie , R.F.D. no 1. - Lawrence - arkansas e (STREET) (CITY) (COUNTY) (STATE) Telephone number 3-1059 Little Rack (EXCHANGE) (NO.) Give name and address of nearest relative or friend in United States: ms mamie 2 Beaucharp -mother sameas Permanent, address (NAME) (RELATIONSHIP) (ADDRESS) PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Public Health Private duty Other (write in) Government Service: Army Farm Security missistant U.S. Deft 02 Agriculture U.S.P.H. Service Veterans Administration Navy U.S.Indian Service Children's Bureau MAJOR RESPONSIBILITIES Adminis- Super Teach- General Private Other of present employment tration vision ing Staff Duty (specify) IF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar: Institutional Public Health Private duty Other (WRITE IN) AVAILABILITY Ifelyise At the present time would you accept assignment to the Army? Yes No Navy? Yes No available Date anytime In case of a war emergency would you accept assignment to the Army? Yes No Navy? Yes No If not now employed would you accept nursing work? Full-time? Yes No Part-time? Yes No T In your own community? Yes No Elsewhere? Yes No Lenehuigner Would you be interested in teaching classes in Home Hygiene and Care of the Sick? yes. Present physical condition Hard Badge No. 30-781 Current date 2-28-41 Name of Committee Little Rock. ankause 3 e D Note: If a nurse does not complete and return this questionnaire, and cannot be located within two years, her enrollment will be removed from our active files. 8

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16
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0
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photo
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2661087
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    "ocrText": "FORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D.C.\nName in full Beauchamp, (SURNAME) LINNIE (FIRST)\nYear of Birth 1892\n(MIDDLE)\nHusband's name -\nPermanent address 2106 North Van Buren st Pulas/91 ANKansas\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address\nfor the next year Havie , R.F.D. no 1. - Lawrence - arkansas\ne\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\n3-1059 Little Rack\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\nms mamie 2 Beaucharp -mother sameas Permanent, address\n(NAME)\n(RELATIONSHIP)\n(ADDRESS)\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nPrivate duty\nOther (write in)\nGovernment Service: Army\nFarm Security missistant\nU.S. Deft 02 Agriculture\nU.S.P.H. Service\nVeterans Administration\nNavy\nU.S.Indian Service\nChildren's Bureau\nMAJOR RESPONSIBILITIES Adminis-\nSuper\nTeach-\nGeneral\nPrivate\nOther\nof present employment tration\nvision\ning\nStaff\nDuty\n(specify)\nIF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther\n(WRITE IN)\nAVAILABILITY\nIfelyise\nAt the present time would you\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable Date anytime\nIn case of a war emergency would you\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\nIf not now employed would you\naccept nursing work? Full-time? Yes\nNo\nPart-time? Yes\nNo\nT\nIn your own community? Yes\nNo\nElsewhere? Yes\nNo\nLenehuigner\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? yes.\nPresent physical condition\nHard\nBadge No. 30-781\nCurrent date 2-28-41\nName of Committee Little Rock. ankause\n3\ne\nD\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enrollment will be removed from our active files.\n8"
}