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+ FORM 1045 AMERICAN RED CROSS REV DEC. 1939 NATIONAL HEADQUARTERS WASHINGTON, D. C. Name in full Sara (SURNAME) he Eray (FIRST) (MIDDLE) Husband's name Permanent address 632858 (STREET) (CITY) N y. ag- (COUNTY) (STATE) Probable address same for the next year (STREET) (CITY) (COUNTY) (STATE) Telephone number General (EXCHANGE) 7. 4536 (NO.) Nearest relative or friend in United States, through whom you may be communicated with in an emergency: Mrs margaret (NAME) Wainmright- (RELATIONSHIP) 891 anisterdam (STREET) ave n.y.c (CITY) Serler (STATE) PRESENT WORK (check below) Name of agency or institution with which employed Institutional Vargining Way hursing Public Health 632654- Private duty Other (write in) S.S Government Service: Army U.S.P.H.Service Veterans Administration Navy U.S. Indian Service Children's Bureau IF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar: Institutional Public Health Private duty Other (write in) Would you respond to an emergency call in event of local or national emergency, such as epidemic, flood, war, etc. If I could he released (Granted of course that you could be released from present employment) Present Tail physical condition Would you be interested in teaching classes in Home Hygiene and Care of the Sick? ho Are you a member of the American Nurses' Association? yes If not, why have you allowed your membership to lapse? Badge No. foot 21979 Current date april 8- 1940 Name of Committee MANHATTAN 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
6
Source index
0
Type
photo
Media ID
3c0a006513d75fe3
Size
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2661552
Core
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Type
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Document identity
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Document source extras
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    "naId": 2661552,
    "coverageEndDate": {
        "day": 27,
        "logicalDate": "1942-01-27",
        "month": 1,
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        "month": 6,
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Page context
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    "ocrText": "+\nFORM 1045\nAMERICAN RED CROSS\nREV DEC. 1939\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nName in full Sara (SURNAME) he Eray\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent address 632858 (STREET) (CITY) N y. ag- (COUNTY)\n(STATE)\nProbable address\nsame\nfor the next year\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number General (EXCHANGE) 7. 4536 (NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan\nemergency: Mrs margaret (NAME) Wainmright- (RELATIONSHIP)\n891 anisterdam (STREET) ave n.y.c (CITY)\nSerler\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\nVargining Way hursing\nPublic Health\n632654-\nPrivate duty\nOther (write in) S.S\nGovernment Service: Army\nU.S.P.H.Service\nVeterans Administration\nNavy\nU.S. Indian Service\nChildren's Bureau\nIF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther (write in)\nWould you respond to an emergency call in event of local or national emergency, such as\nepidemic,\nflood, war, etc. If I could he released\n(Granted of course that you could be released from present employment)\nPresent Tail\nphysical condition\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? ho\nAre you a member of the American Nurses' Association?\nyes\nIf not, why have you allowed your membership to lapse?\nBadge No. foot 21979\nCurrent date april 8- 1940\nName of Committee\nMANHATTAN\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."
}