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3rd and
Form 1045-Rev. 2-16-21
NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER, PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
CALVIN COOLIDGE, VICE PRESIDENT
CHARLES EVANS HUGHES, VICE PRESIDENT
THE AMERICAN RED CROSS
MRS. AUGUST BELMONT
CORNELIUS N. BLISS
THOMAS D. THACHER, COUNSELOR
MABEL T. BOARDMAN
OGDEN L. MILLS, TREASURER
NATIONAL HEADQUARTERS
WILLIAM R. CASTLE, JR.
MRS. HENRY P. DAVISON
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D. C.
MRS. FRANK v. HAMMAR
SAMUEL KNIGHT
OGDEN L. MILLS
NATIONAL EXECUTIVE OFFICERS
MAJ. GEN. ROBERT u. PATTERSON
GUSTAVUS D. POPE
JOHN BARTON PAYNE, CHAIRMAN
MRS.
JAMES L. FIESER, VICE CHAIRMAN
REAR ADMIRAL CHARLES E. RIGGS
ERNEST P. BICKNELL, VICE CHAIRMAN
3dd
JOHN D. RYAN
GEORGE E. SCOTT
JAMES K. McCLINTOCK, VICE CHAIRMAN
HENRY UPSON SIMS
THOMAS D. THACHER
ELIOT WADSWORTH
APR 151932
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in enclosed envelope, at the eariest possible date.
IMPORTANT:
In order to render prompt service
Yours sincerely,
in time of disaster, enrolled Red Cross
MISS HARRIET E. COLE
Chairman or
Nurses should report at once to the
MARTTORD HOUPTTÄL
Secretary.
Secretary of the Local Committee under
HARTFORD, CONN.
which they are enrolled. Do not forget
Local Committee.
the address of the Secretary.
Name in full
Jane Eligabeth Hitchcock
If married, give husband's name
Permanent address 185, So. Whitney St.- Hartford
Conni
(STREET, ETC.)
(EITY)
(COUNTY)
(STATE)
Probable address for the next year 185 do. whitney St.
(STREET, ETC.)
Telephone No. 4-8437
Hartford
Conn.
(CITY)
(COUNTY)
(STATE)
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Underline Brother, Albert Hitchcock, Southbridge (R.D.)2) mass.
the type of work you are now doing: Retired.
Army - Navy - U.S.P.H. Service - U.S.Vet. Administration U.S. Indian Service
-
Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no
Have you ever been? Yes. During the wat-
Indicate present physical condition excellent.
Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? Yes,
Badge No. 6578
Current date may , 24, 1932
NOTE.--If the nurse does not complete and return this questionnaire, and can not be
&
located within two years, her enrolment will be annulled.
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"ocrText": "I\n+\nC\n3rd and\nForm 1045-Rev. 2-16-21\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE, VICE PRESIDENT\nCHARLES EVANS HUGHES, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMRS. AUGUST BELMONT\nCORNELIUS N. BLISS\nTHOMAS D. THACHER, COUNSELOR\nMABEL T. BOARDMAN\nOGDEN L. MILLS, TREASURER\nNATIONAL HEADQUARTERS\nWILLIAM R. CASTLE, JR.\nMRS. HENRY P. DAVISON\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D. C.\nMRS. FRANK v. HAMMAR\nSAMUEL KNIGHT\nOGDEN L. MILLS\nNATIONAL EXECUTIVE OFFICERS\nMAJ. GEN. ROBERT u. PATTERSON\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE, CHAIRMAN\nMRS.\nJAMES L. FIESER, VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nERNEST P. BICKNELL, VICE CHAIRMAN\n3dd\nJOHN D. RYAN\nGEORGE E. SCOTT\nJAMES K. McCLINTOCK, VICE CHAIRMAN\nHENRY UPSON SIMS\nTHOMAS D. THACHER\nELIOT WADSWORTH\nAPR 151932\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the eariest possible date.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nMISS HARRIET E. COLE\nChairman or\nNurses should report at once to the\nMARTTORD HOUPTTÄL\nSecretary.\nSecretary of the Local Committee under\nHARTFORD, CONN.\nwhich they are enrolled. Do not forget\nLocal Committee.\nthe address of the Secretary.\nName in full\nJane Eligabeth Hitchcock\nIf married, give husband's name\nPermanent address 185, So. Whitney St.- Hartford\nConni\n(STREET, ETC.)\n(EITY)\n(COUNTY)\n(STATE)\nProbable address for the next year 185 do. whitney St.\n(STREET, ETC.)\nTelephone No. 4-8437\nHartford\nConn.\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nUnderline Brother, Albert Hitchcock, Southbridge (R.D.)2) mass.\nthe type of work you are now doing: Retired.\nArmy - Navy - U.S.P.H. Service - U.S.Vet. Administration U.S. Indian Service\n-\nPublic Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been? Yes. During the wat-\nIndicate present physical condition excellent.\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ? Yes,\nBadge No. 6578\nCurrent date may , 24, 1932\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\n&\nlocated within two years, her enrolment will be annulled."
}