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I
am
Richland lo. ohio
coopchilishlawk lo
Mrs.
M
JAN 1 91944
FORM 1045
REV. OCT. 1943
AMERICAN RED CROSS
NURSING SERVICE
ANNUAL QUESTIONNAIRE-1944
Red Cross
HD7669
If you have changed your last name
Badge number
since contacting us, please check here.
Name in full
Daum
Ruth
Guthrie
Tel. No. Ashland
(last)
(first)
(middle)
If married, give maiden name Ruth Guthrie
Date of birth Oct.3-1897
Marital status. Widowed Dec. I4-I943
Husband's name
J.R.Daum
(single, married, widowed, divorced)
Ist.
Permanent address
4th
Ashland
Ashland
Ohio,
after Feb.
(street)
(city)
(county)
(state)
uthi
h
Present address
Crestline
Crawford
Ohio
(street)
(city)
(county)
1s
=
Notify national headquarters immediately if you change your address.
e
Give name and address of nearest relative or friend in the United States:
Mrs.S.A.Davis
IOOI Champion Ave.Columbus 6,0hio
Sister
(name)
(address)
(relationship)
F
Are you employed in nursing at the present time? Yes
No
Expect to go to work Feb.Ist.
0
If employed, check the type of work you are doing and fill in below the title of your position and the name
T
and address of the agency or institution:
(1)
Institutional
Public Health
Industrial
Private Duty
Other
s
Public Health Nurse, Ashland County Board of Health, Court House, Aghland
Ohio.
If not employed, what type of nursing would you prefer to render? Overseas,
IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND
ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX
AVAILABILITY FOR SERVICE WITH THE ARMED FORCES
Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45.
She
may be single or married, but if married she must have no dependents under 14 years of age.
If eligible and not already in service with the armed forces, are you:
Immediately available?
Available in the near future?
(specify date)
Not available, for the following reason?
(specify)
Do you have any dependents under 14 years of age? Yes
No)
No children
AVAILABILITY FOR SERVICE WITH CIVILIANS
I
If qualified and not already doing so, will you be available:
To teach Red Cross Home Nursing classes?
To teach volunteer nurse's aides?
07/24/04
J
To take a Red Cross emergency assignment? Yes
Yes
To serve overseas caring for civilians?
Have you ever served with the Red Cross in a disaster? Yes
No
If yes, specify type of disaster
Page data
- Page
- 13
- Source index
- 0
- Type
- photo
- Media ID
- 708edea690255e1a
- Size
- unknown
Document data
- ID
- 2661311
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Page context
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"ocrText": "I\nam\nRichland lo. ohio\ncoopchilishlawk lo\nMrs.\nM\nJAN 1 91944\nFORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nRed Cross\nHD7669\nIf you have changed your last name\nBadge number\nsince contacting us, please check here.\nName in full\nDaum\nRuth\nGuthrie\nTel. No. Ashland\n(last)\n(first)\n(middle)\nIf married, give maiden name Ruth Guthrie\nDate of birth Oct.3-1897\nMarital status. Widowed Dec. I4-I943\nHusband's name\nJ.R.Daum\n(single, married, widowed, divorced)\nIst.\nPermanent address\n4th\nAshland\nAshland\nOhio,\nafter Feb.\n(street)\n(city)\n(county)\n(state)\nuthi\nh\nPresent address\nCrestline\nCrawford\nOhio\n(street)\n(city)\n(county)\n1s\n=\nNotify national headquarters immediately if you change your address.\ne\nGive name and address of nearest relative or friend in the United States:\nMrs.S.A.Davis\nIOOI Champion Ave.Columbus 6,0hio\nSister\n(name)\n(address)\n(relationship)\nF\nAre you employed in nursing at the present time? Yes\nNo\nExpect to go to work Feb.Ist.\n0\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nT\nand address of the agency or institution:\n(1)\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\ns\nPublic Health Nurse, Ashland County Board of Health, Court House, Aghland\nOhio.\nIf not employed, what type of nursing would you prefer to render? Overseas,\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45.\nShe\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you:\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason?\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo)\nNo children\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nI\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes?\nTo teach volunteer nurse's aides?\n07/24/04\nJ\nTo take a Red Cross emergency assignment? Yes\nYes\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf yes, specify type of disaster"
}