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I I 0 e 0 lo FORM 1045 REV 1-2-35 THE AMERICAN RED CROSS a M NATIONAL HEADQUARTERS WASHINGTON, D. c. +L 5 TS, D III ? a Dear Madam: rb + + The National Committee on Red Cross Nursing Service requires us to submit, 5 annually, a report of all the Red Cross Nurses enrolled with our Committee. Will you therefore, please answer the following questions and return this form to me, in the enclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED WITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec- ognize the value of filing this information and will return the questionnaire promptly, P.P. as we are extremely anxious to make a very complete report to National Headquarters. a C IMPORTANT: Yours sincerely, In order to render prompt service Chairman or in time of disaster, enrolled Red Cross T. Eleca Smitters, + J. Nurses should report at once to the SMITTEN, Secretary Secretary of the Local Committee under Secretary Local Committee RED CROSS NURSING SERVICE Local Committee. en which they are enrolled. Do not forget 519 Smithfield St. the address of the Secretary. PITTSBURGH. PA. Name in full Edith Patter Today A Permanent If married, address give husband's 106 the name Boulward John Peaces. (STREET, ETC.) (CITY) (STATE) Probable address for the next year 106 The Boulward ( Carriehol Telephone No. Carrich 4694 Pitle hugh, ISTREET, Allegbery ETCA Perms (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) mr Underl ine John the type O. of work Hooky you ar e/ now (Husband/ doing: 106 The Bruleyard, Pitts hergh Carrick Penion Army - Navy - U.S.P.H. Service - Veterans 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? Have you ever been? Indicate present physical condition good Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? yes. Badge No. 45-438. Current date February 28, 1938. NOTE.--If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrolment will be removed from our active files. I 3 8

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Page context
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    "ocrText": "I I\n0\ne\n0\nlo\nFORM 1045\nREV 1-2-35\nTHE AMERICAN RED CROSS\na\nM\nNATIONAL HEADQUARTERS\nWASHINGTON, D. c.\n+L\n5\nTS,\nD\nIII\n?\na\nDear Madam:\nrb\n+\n+\nThe National Committee on Red Cross Nursing Service requires us to submit,\n5\nannually, a report of all the Red Cross Nurses enrolled with our Committee. Will you\ntherefore, please answer the following questions and return this form to me, in the\nenclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED\nWITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-\nognize the value of filing this information and will return the questionnaire promptly,\nP.P.\nas we are extremely anxious to make a very complete report to National Headquarters.\na C\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nChairman or\nin time of disaster, enrolled Red Cross\nT. Eleca Smitters,\n+\nJ.\nNurses should report at once to the\nSMITTEN,\nSecretary\nSecretary of the Local Committee under\nSecretary Local Committee\nRED CROSS NURSING SERVICE\nLocal Committee.\nen\nwhich they are enrolled. Do not forget\n519 Smithfield St.\nthe address of the Secretary.\nPITTSBURGH. PA.\nName in full Edith Patter Today A\nPermanent If married, address give husband's 106 the name Boulward John Peaces.\n(STREET, ETC.)\n(CITY)\n(STATE)\nProbable address for the next year 106 The Boulward ( Carriehol\nTelephone No. Carrich 4694 Pitle hugh, ISTREET, Allegbery ETCA Perms\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)\nmr Underl ine John the type O. of work Hooky you ar e/ now (Husband/ doing: 106 The Bruleyard, Pitts hergh Carrick Penion\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -\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?\nHave you ever been?\nIndicate present physical condition good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ? yes.\nBadge No. 45-438.\nCurrent date February 28, 1938.\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be removed from our active files.\nI\n3\n8"
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