Ask the Scholar
Page 7 of 125
I can add historical knowledge about this page.
Page image
OCR
ITT
L
s
s
AMERICAN RED CROSS
NURSE QUESTIONNAIRE
FORM 1045 E (2-46)
(FOR RED CROSS NURSES NOW SERVING OR WHO HAVE SERVED WITH THE ARMY OR NAVY)
RED CROSS BADGE NUMBER
MILITARY SERIAL NO.
85878
n-744004
CHECK IF LAST NAME HAS CHANGED
NAME (last, first, middle)
TELEPHONE NUMBER
EUANS, LilliAn
Ar/ 1473W
IF MARRIED, GIVE MAIDEN NAME
HUSBAND'S NAME
PERMANENT ADDRESS (street, city, zone, county, state)
PRESENT
40 ADDRESS Wes/minster Ave. UNTIL
WHAT DATE DO YOU EXPECT
sAme AS Above
TO BE AT THIS ADDRESS?
permanently
NAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES
RELATIONSHIP
mary m.EuAns - 40 WesTminsTen Ave. Arlingtm, mass
mother
DATE of BIRTH (mo., day, yr.)
at, 13, 1918
SINGLE
MARRIED
SEPARATED
WI DOWED
DIVORCED
WHAT LANGUAGES, OTHER THAN ENGLISH, DO YOU SPEAK?
none
GRADUATE OF HIGH SCHOOL?
YES
NO
COLLEGE OR UNIVERSITY ATTENDED
LOCATION
INCLUSIVE DATES
DEG. OR DIPLOMA
MAJOR
COURSES TAKEN WHILE IN ARMY OR NAVY PSYCHIATRY
ANAESTHESIA
DIETETICS
OPERATING ROOM TECHNI QUE
(show no. of months) none
DATE OF SEPARATION FROM ARMED FORCES 3 an " 46
IF STILL IN SERVICE GIVE PROBABLE DATE OF SEPARATION
IF EARLY SEPARATION IS ANTICIPATED, GIVE ADDRESS TO WHICH YOU EXPECT TO GO
ARE YOU CURRENTLY
STATE IN WHICH REGISTERED LAST DATE
REGISTERED?
YES
ARE YOU CURRENTLY A MEMBER
NO
MASS,
SepT 12,
OF THE AMER. NURSES' ASSOC.?
YES
NO
PRESENT EMPLOYMENT -- IF NOT EMPLOYED CHECK HERE
D
POSITION TITLE (instructor, supervisor, head nurse, staff nurse, private duty,etc.) SERVICE (medicine, surgery, etc.)
NAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED
student - Simmons College Public Health nursing Course. - AnTicipATe completing
CITY AND STATE
Feb.1947
HEALTH
IF OTHER THAN GOOD, SPECIFY NATORE AND ANTICIPATED DURATION OF DISABILITY
good
VOLUNTEER SERVICE FOR AMERICAN RED CROSS
The purpose of the following statements is to identif2 the nurses who can be counted upon to respond to a call to
assist the Red Cross in any of the following ways. Please check the "Yes" box only if you are willing and able to
serve if called on within the next 12 months. Those in service indicate probable intention following separation.
They will not be called upon while in service.
NAME AND ADRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS IF NOT IN MILITARY SERVICE
Boston metropilitan, Chnp. 575 Boy lston street Boston MASS.
1. TEACH HOME
YES
ATTEND AN INSTRUCTOR'S TRAINING PROGRAM, IF OFFERED. (Funds are available
NURSING CLASSES
NO
for training home nursing instructors. See local chaprer.)
YES
NO
2. SERVE IN CASE
ONLY IN HOME
IN OTHER
ATTEND DISASTER INSTITUTES, IF
OF DISASTER
YES
NO
COMMUNITY
COMMUNITIES
OFFERED, IN PREP. FOR SERVICE
YES
NO
3. TEACH NURSE'S
ACCEPT MEMBERSHIP ON CHAPTER
ASSIST WITH OTHER
AIDE CLASSES
YES
NO
COMMITTEE SHOULD SERVICES BE NEEDED
YES
NO
CHAPTER PROGRAMS
YES
NO
AS NEEDED.
IF YOU HAVE NOT ANSWERED "YES" TO ANY OF THE QUESTIONS LISTED UNDER VOLUNTEER SERVICE, DO YOU ANTICIPATE THAT
YOU WILL BE ABLE TO SERVE AT SOME TIME IN THE FUTURE?
YES
NO
IF UNABLE TO SERVE, GIVE MAJOR REASONS
C4-25-46
DATE
SIGNATORE
11 april 1946
Lillain Evans
YOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR FAITHFULNESS IN KEEPING US INFORMED
8
OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE AND RETURN IT PROMPTLY TO THE COMMITTEE NAMED BELOW.
ATTENTION SECRETARY
FILL IN COMMITTEE NAME AND ADDRESS BEFORE SENDING QUESTIONNAIRE TO NUR SE:
NURSE RECRUITMENT
COMMITTEE
NURSE RECRUITMENT STATION
575 Boylston Street, Boston 16. Mass
-80408M
Page data
- Page
- 7
- Source index
- 0
- Type
- photo
- Media ID
- 78b49a37b2680ff9
- Size
- unknown
Document data
- ID
- 2661439
- Core
- doc
- Type
- document
DTO data
{
"id": "2661439",
"sourceUrl": "https://catalog.archives.gov/id/2661439",
"contentType": "document",
"title": "Evans, Lillian",
"citationUrl": "https://catalog.archives.gov/id/2661439",
"collections": [
"Records of the American National Red Cross",
"Historical Nurse Files"
],
"iiifBase": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships/40033/0001/DCD00073/40033_1521003239_0549/40033_1521003239_0549-00232.jpg",
"thumbnailUrl": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships/40033/0001/DCD00073/40033_1521003239_0549/40033_1521003239_0549-00232.jpg",
"largeImageUrl": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships/40033/0001/DCD00073/40033_1521003239_0549/40033_1521003239_0549-00232.jpg",
"imageCount": 125,
"hasImages": true,
"source": "import",
"hasTranscription": false
}
Context sent to Scholar
Document identity
{
"localId": "2661439",
"label": "Evans, Lillian",
"core": "doc",
"dtoType": "document",
"citationUrl": "https://catalog.archives.gov/id/2661439"
}
Document source metadata
{
"id": "2661439",
"sourceUrl": "https://catalog.archives.gov/id/2661439",
"contentType": "document",
"title": "Evans, Lillian",
"citationUrl": "https://catalog.archives.gov/id/2661439",
"collections": [
"Records of the American National Red Cross",
"Historical Nurse Files"
],
"iiifBase": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships/40033/0001/DCD00073/40033_1521003239_0549/40033_1521003239_0549-00232.jpg",
"thumbnailUrl": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships/40033/0001/DCD00073/40033_1521003239_0549/40033_1521003239_0549-00232.jpg",
"largeImageUrl": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships/40033/0001/DCD00073/40033_1521003239_0549/40033_1521003239_0549-00232.jpg",
"imageCount": 125,
"hasImages": true,
"source": "import",
"hasTranscription": false
}
Document source extras
{
"url": "https://catalog.archives.gov/id/2661439",
"naId": 2661439,
"coverageEndDate": {
"day": 3,
"logicalDate": "1981-03-03",
"month": 3,
"year": 1981
},
"coverageStartDate": {
"day": 14,
"logicalDate": "1941-04-14",
"month": 4,
"year": 1941
},
"levelOfDescription": "fileUnit",
"recordType": "description",
"ocrSource": "nara-archive"
}
Page context
{
"seq": 7,
"pageIndex": 0,
"type": "photo",
"url": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships/40033/0001/DCD00073/40033_1521003239_0549/40033_1521003239_0549-00238.jpg",
"mediaId": "78b49a37b2680ff9",
"ocrText": "ITT\nL\ns\ns\nAMERICAN RED CROSS\nNURSE QUESTIONNAIRE\nFORM 1045 E (2-46)\n(FOR RED CROSS NURSES NOW SERVING OR WHO HAVE SERVED WITH THE ARMY OR NAVY)\nRED CROSS BADGE NUMBER\nMILITARY SERIAL NO.\n85878\nn-744004\nCHECK IF LAST NAME HAS CHANGED\nNAME (last, first, middle)\nTELEPHONE NUMBER\nEUANS, LilliAn\nAr/ 1473W\nIF MARRIED, GIVE MAIDEN NAME\nHUSBAND'S NAME\nPERMANENT ADDRESS (street, city, zone, county, state)\nPRESENT\n40 ADDRESS Wes/minster Ave. UNTIL\nWHAT DATE DO YOU EXPECT\nsAme AS Above\nTO BE AT THIS ADDRESS?\npermanently\nNAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES\nRELATIONSHIP\nmary m.EuAns - 40 WesTminsTen Ave. Arlingtm, mass\nmother\nDATE of BIRTH (mo., day, yr.)\nat, 13, 1918\nSINGLE\nMARRIED\nSEPARATED\nWI DOWED\nDIVORCED\nWHAT LANGUAGES, OTHER THAN ENGLISH, DO YOU SPEAK?\nnone\nGRADUATE OF HIGH SCHOOL?\nYES\nNO\nCOLLEGE OR UNIVERSITY ATTENDED\nLOCATION\nINCLUSIVE DATES\nDEG. OR DIPLOMA\nMAJOR\nCOURSES TAKEN WHILE IN ARMY OR NAVY PSYCHIATRY\nANAESTHESIA\nDIETETICS\nOPERATING ROOM TECHNI QUE\n(show no. of months) none\nDATE OF SEPARATION FROM ARMED FORCES 3 an \" 46\nIF STILL IN SERVICE GIVE PROBABLE DATE OF SEPARATION\nIF EARLY SEPARATION IS ANTICIPATED, GIVE ADDRESS TO WHICH YOU EXPECT TO GO\nARE YOU CURRENTLY\nSTATE IN WHICH REGISTERED LAST DATE\nREGISTERED?\nYES\nARE YOU CURRENTLY A MEMBER\nNO\nMASS,\nSepT 12,\nOF THE AMER. NURSES' ASSOC.?\nYES\nNO\nPRESENT EMPLOYMENT -- IF NOT EMPLOYED CHECK HERE\nD\nPOSITION TITLE (instructor, supervisor, head nurse, staff nurse, private duty,etc.) SERVICE (medicine, surgery, etc.)\nNAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED\nstudent - Simmons College Public Health nursing Course. - AnTicipATe completing\nCITY AND STATE\nFeb.1947\nHEALTH\nIF OTHER THAN GOOD, SPECIFY NATORE AND ANTICIPATED DURATION OF DISABILITY\ngood\nVOLUNTEER SERVICE FOR AMERICAN RED CROSS\nThe purpose of the following statements is to identif2 the nurses who can be counted upon to respond to a call to\nassist the Red Cross in any of the following ways. Please check the \"Yes\" box only if you are willing and able to\nserve if called on within the next 12 months. Those in service indicate probable intention following separation.\nThey will not be called upon while in service.\nNAME AND ADRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS IF NOT IN MILITARY SERVICE\nBoston metropilitan, Chnp. 575 Boy lston street Boston MASS.\n1. TEACH HOME\nYES\nATTEND AN INSTRUCTOR'S TRAINING PROGRAM, IF OFFERED. (Funds are available\nNURSING CLASSES\nNO\nfor training home nursing instructors. See local chaprer.)\nYES\nNO\n2. SERVE IN CASE\nONLY IN HOME\nIN OTHER\nATTEND DISASTER INSTITUTES, IF\nOF DISASTER\nYES\nNO\nCOMMUNITY\nCOMMUNITIES\nOFFERED, IN PREP. FOR SERVICE\nYES\nNO\n3. TEACH NURSE'S\nACCEPT MEMBERSHIP ON CHAPTER\nASSIST WITH OTHER\nAIDE CLASSES\nYES\nNO\nCOMMITTEE SHOULD SERVICES BE NEEDED\nYES\nNO\nCHAPTER PROGRAMS\nYES\nNO\nAS NEEDED.\nIF YOU HAVE NOT ANSWERED \"YES\" TO ANY OF THE QUESTIONS LISTED UNDER VOLUNTEER SERVICE, DO YOU ANTICIPATE THAT\nYOU WILL BE ABLE TO SERVE AT SOME TIME IN THE FUTURE?\nYES\nNO\nIF UNABLE TO SERVE, GIVE MAJOR REASONS\nC4-25-46\nDATE\nSIGNATORE\n11 april 1946\nLillain Evans\nYOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR FAITHFULNESS IN KEEPING US INFORMED\n8\nOF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE AND RETURN IT PROMPTLY TO THE COMMITTEE NAMED BELOW.\nATTENTION SECRETARY\nFILL IN COMMITTEE NAME AND ADDRESS BEFORE SENDING QUESTIONNAIRE TO NUR SE:\nNURSE RECRUITMENT\nCOMMITTEE\nNURSE RECRUITMENT STATION\n575 Boylston Street, Boston 16. Mass\n-80408M"
}