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HG
squdies lechanged
FORM 1045
REV. JAN 1941
AMERICAN RED CROSS
NATIONAL HEADQUARTERS
WASHINGTON, D. C.
Name in full Gaskill
Ina
M
Year of Birth 12-2-84
(SURNAME)
(FIRST)
(MIDDLE)
Husband's name
Permanent
address 623 East 53 St (CITY) Indianapolin (COUNTY) Indiana (STATE)
(STREET)
Probable address
for the next year
same
I
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone number
Hu 7934
(EXCHANGE)
(NO.)
Give name and address of nearest relative or friend in United States:
Mary A Meyers
friend
/
same as above
(NAME)
(RELATIONSHIP)
(ADDRESS)
PRESENT EMPLOYMENT (check below)
Name of agency or institution with which employed
Institutional
Public Health
Shortridge High School, Indianapol
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? am doing 20
Present physical condition disabled probably for next few months
Badge No. 1761
Current date Marl, 19/4/
Name of Committee
Indianapolis
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
- 22
- Source index
- 0
- Type
- photo
- Media ID
- 7c8aae8852ce6690
- Size
- unknown
Document data
- ID
- 2661518
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source extras
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Page context
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"ocrText": "HG\nsqudies lechanged\nFORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nName in full Gaskill\nIna\nM\nYear of Birth 12-2-84\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent\naddress 623 East 53 St (CITY) Indianapolin (COUNTY) Indiana (STATE)\n(STREET)\nProbable address\nfor the next year\nsame\nI\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\nHu 7934\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\nMary A Meyers\nfriend\n/\nsame as above\n(NAME)\n(RELATIONSHIP)\n(ADDRESS)\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nShortridge High School, Indianapol\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 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? am doing 20\nPresent physical condition disabled probably for next few months\nBadge No. 1761\nCurrent date Marl, 19/4/\nName of Committee\nIndianapolis\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."
}