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FORM 1045
REV. JAN 1941
M
M
NATIONAL HEADQUARTERS
FEB 15 1941
ar
T
AMERICAN RED CROSS
S
WASHINGTON, D. C.
Name in full cash. Marie
Rhodes
Year of Birth 9-23-87
(SÚRNAME)
(FIRST)
(MIDDLE)
3
(wid.)
Husband's name
Veterans Admin. Facility, Lake City, Fla.
Permanent address
Columbia County
(STREET)
(CITY)
(COUNTY)
(STATE)
Probable address
Same
or withingVAA Service.
for the next year
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone number
none
(EXCHANGE)
(NO.)
Give name and address of nearest relative or friend in United States:
Mrs Franklin P. Booth, 3301 Beechwood , Blvd. Pittsburgh, Pa
(NAME)
(RELATIONSHIP
UNT
(ADDRESS)
PRESENT EMPLOYMENT (check below)
Name of agency or institution with which employed
Institutional
X
Public Health
Private duty
Other (write in)
Government Service: Army
U.S.P.H. Service
Veterans Administration
X
Navy
U.S.Indian Service
Children's Bureau
es
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
upon
approval
At the present time would you
accept assignment to the Army? Yes
No
Navy? Yes
No
available Date U.a
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?
Good
Present physical condition
Badge No. 13,633
Current date
Feb. 24,1941
NATIONAL
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.
Page data
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- Source index
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- Type
- photo
- Media ID
- 7d456dabcde84634
- Size
- unknown
Document data
- ID
- 2661226
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "FORM 1045\nREV. JAN 1941\nM\nM\nNATIONAL HEADQUARTERS\nFEB 15 1941\nar\nT\nAMERICAN RED CROSS\nS\nWASHINGTON, D. C.\nName in full cash. Marie\nRhodes\nYear of Birth 9-23-87\n(SÚRNAME)\n(FIRST)\n(MIDDLE)\n3\n(wid.)\nHusband's name\nVeterans Admin. Facility, Lake City, Fla.\nPermanent address\nColumbia County\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address\nSame\nor withingVAA Service.\nfor the next year\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\nnone\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\nMrs Franklin P. Booth, 3301 Beechwood , Blvd. Pittsburgh, Pa\n(NAME)\n(RELATIONSHIP\nUNT\n(ADDRESS)\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nX\nPublic Health\nPrivate duty\nOther (write in)\nGovernment Service: Army\nU.S.P.H. Service\nVeterans Administration\nX\nNavy\nU.S.Indian Service\nChildren's Bureau\nes\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\nupon\napproval\nAt the present time would you\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable Date U.a\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\nIn your own community? Yes\nNo\nElsewhere? Yes\nNo\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick?\nGood\nPresent physical condition\nBadge No. 13,633\nCurrent date\nFeb. 24,1941\nNATIONAL\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."
}