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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
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- Source index
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- Type
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- Media ID
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Document data
- ID
- 2661552
- Core
- doc
- Type
- document
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Context sent to Scholar
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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."
}