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Colvin, Mrs. Amy M. (Henry) nee Amy M. Hilliard

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I 5 FORM 1045 REV. JAN 1941 D AMERICAN RED CROSS me 5 M NATIONAL HEADQUARTERS T WASHINGTON, D.C. S Name in full Coloin, (SURNAME) any (FIRST) way dieliard (MIDDLE) Year of Birth 1872 D Husband's name Heury Colum - decead Permanent address 42 second (STREET) (CITY) Tray Rensselaes (COUNTY) Co neirfuk (STATE) in I Probable address for the next year same (STREET) (CITY) (COUNTY) (STATE) Telephone number Tray (EXCHANGE) 2696 - J (NO.) M. Give name and address of nearest relative or friend in United States: (NAME) worker (RELATIONSHIP) - 5, Kennor (ADDRESS) are heevark u.f. PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional - 5 Public Health - 1 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 (N) AVAILABILITY my full time after graduation was given to executive hospetal work 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? Present physical condition Good Badge No. 677 Current date Warch 0/1941 Name of Committee albany n.y c 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

Page
17
Source index
0
Type
photo
Media ID
3dd62b5095a0257c
Size
unknown

Document data

ID
2661263
Core
doc
Type
document
DTO data 
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Context sent to Scholar

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        "day": 15,
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        "month": 5,
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    "ocrText": "I\n5\nFORM 1045\nREV. JAN 1941\nD\nAMERICAN RED CROSS\nme\n5\nM\nNATIONAL HEADQUARTERS\nT\nWASHINGTON, D.C.\nS\nName\nin full Coloin, (SURNAME) any (FIRST) way dieliard (MIDDLE) Year of Birth 1872\nD\nHusband's name\nHeury Colum - decead\nPermanent address 42 second\n(STREET)\n(CITY)\nTray\nRensselaes (COUNTY) Co neirfuk (STATE)\nin\nI\nProbable address\nfor the next year\nsame\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\nTray (EXCHANGE) 2696 - J (NO.)\nM.\nGive name and address of nearest relative or friend in United States:\n(NAME) worker (RELATIONSHIP) - 5, Kennor (ADDRESS) are heevark u.f.\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\n-\n5\nPublic Health\n-\n1\nPrivate duty\n-\nOther (write in) -\nGovernment Service: Army\n-\nU.S.P.H. Service\n-\nVeterans Administration\n-\nNavy\n-\nU.S.Indian Service - Children's Bureau\n-\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\n-\nOther\n-\n(WRITE (N)\nAVAILABILITY\nmy full time after graduation was given to executive hospetal\nwork\nAt the present time would you\nDate\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable\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?\nPresent physical condition Good\nBadge No. 677\nCurrent date Warch 0/1941\nName\nof Committee albany n.y\nc\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."
}