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FORM 1045 REV.JAN 1941 AMERICAN RED CROSS 2 NATIONAL HEADQUARTERS WASHINGTON, D. C. Name in full Sara m Gray Year of Birth Dec 1886 (SURNAME) (FIRST) (MIDDLE) Husband's name Permanent address % Mr (STREET) m fredden (CITY) 225 E (COUNTY) 202 of or 63268 (STATE) Sl-wyce Probable address for the next year same (STREET) (CITY) (COUNTY) (STATE) Telephone number Sed 6486 Gram 74536 (EXCHANGE) (NO.) Give name and address of nearest relative or friend in United States: mm (NAME) m 3 ammight (RELATIONSHIP) Bingham Hosp. Causadeuqua. (ADDRESS) 4.4 PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Social Service Virginia Way hubely Public Health 6328 50sl. City 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 would do anything that would help. but Too old to go other with army or hand. excepting extreme Emergency 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? No Present physical condition Fair. Badge No. fost hadge Current date feb 3. MANHATTAN Name of Committee 2019.1946 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.

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5
Source index
0
Type
photo
Media ID
5c06fdda9007f341
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unknown

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ID
2661552
Core
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Type
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DTO data
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Document identity
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    "coverageEndDate": {
        "day": 27,
        "logicalDate": "1942-01-27",
        "month": 1,
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        "logicalDate": "1918-06-04",
        "month": 6,
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Page context
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    "ocrText": "FORM 1045\nREV.JAN 1941\nAMERICAN RED CROSS\n2\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nName in full Sara m Gray\nYear of Birth Dec 1886\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent address % Mr (STREET) m fredden (CITY) 225 E (COUNTY) 202 of or 63268 (STATE) Sl-wyce\nProbable address\nfor the next year\nsame\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number Sed 6486\nGram 74536\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\nmm (NAME) m 3 ammight (RELATIONSHIP) Bingham Hosp. Causadeuqua. (ADDRESS) 4.4\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional Social Service\nVirginia Way hubely\nPublic Health\n6328 50sl. City\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 would do anything that would help. but Too old to go other\nwith army or hand. excepting extreme Emergency\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?\nNo\nPresent physical condition Fair.\nBadge No. fost hadge\nCurrent date feb 3.\nMANHATTAN\nName of Committee\n2019.1946\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."
}