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B FORM 1045 REV. JAN 1941 AMERICAN RED CROSS NATIONAL HEADQUARTERS WASHINGTON, D. c. Name in full Bush (SURNAME) Sarah (FIRST) gertrude (MIDDLE) Year of Birth 1888 Husband's name Permanent address 192 E Como Are Columbus Franklin Ohio (STREET) (CITY) (COUNTY) (STATE) G Probable address same e for the next year (STREET) (CITY) (COUNTY) (STATE) Telephone number La 6915 (EXCHANGE) (NO.) Give name and address of nearest relative or friend in United States: Bush EllAMrs. Mother 132 E. Como Ave Columbus G (NAME) (RELATIONSHIP) (ADDRESS) PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Public Health Ohio wept of Health Private duty Other (write in) Government Service: Army 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 At the present time would you Date accept assignment to the Army? Yes No Navy? Yes No available 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 In your own community? Yes No Elsewhere? Yes No Would you be interested in teaching classes in Home Hygiene and Care of the Sick? No U Present physical condition go Badge No. 20614 Columbus Ohw Current date Jan-24-1940 Name of Committee 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.

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    "ocrText": "B\nFORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. c.\nName in full Bush\n(SURNAME)\nSarah (FIRST) gertrude (MIDDLE) Year of Birth\n1888\nHusband's name\nPermanent address\n192 E Como Are Columbus Franklin\nOhio\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nG\nProbable address\nsame\ne\nfor the next year\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\nLa\n6915\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\nBush EllAMrs. Mother\n132 E. Como Ave Columbus G\n(NAME)\n(RELATIONSHIP)\n(ADDRESS)\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nOhio wept of Health\nPrivate duty\nOther (write in)\nGovernment Service: Army\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\nAt the present time would you\nDate\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable\nIn\ncase 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\nIn your own community? Yes\nNo\nElsewhere? Yes\nNo\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? No\nU\nPresent physical condition go\nBadge No. 20614\nColumbus Ohw\nCurrent date Jan-24-1940\nName of Committee\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."
}