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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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- Source index
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- Type
- photo
- Media ID
- b280c067cc4cca56
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Document data
- ID
- 2661087
- Core
- doc
- Type
- document
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Context sent to Scholar
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Document source extras
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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"
}