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FORM 1045 REV. 12-3-37 THE AMERICAN RED CROSS NATIONAL HEADQUARTERS WASHINGTON, D. C. QUESTIONNAIRES DESTROYED Dear Red Cross Nurse: The National Committee on Red Cross Nursing Service requires us to submit, 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, as we are extremely anxious to make a very complete report to National Headquarters. IMPORTANT: In order to render prompt service Yours sincerely, in time of disaster, enrolled Red Cross Lucile M. Highy Chairman or Nurses should report at once to the Secretary. Secretary of the Local Committee under which they are enrolled. Do not forget Oregon Local Committee. the address of the Secretary. Name in full LEPRESTRE - Generier If married, give husband's name Permanent address 118 N. (STREET, W.22nd ETC.) Place (CITY) Portaned (COUNTY) multnowals, (STATE) oregon Probable address for the next year same (STREET, ETC.) Telephone No. Be 8217 Portteud (CITY) hultuomah (COUNTY) (STATE) organ Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Rene' Leprestre Father - 0/00 Dorland International Underline the type of work you are now doing: Rockifeller R.C.A. Building kees 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? NO Have you ever been? NO - Indicate present physical condition good Would you respond to an emergency call in event of epidemic, disaster, war, etc. Yes Badge No. 62545 Current date 5-16-38- 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.

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    "ocrText": "FORM 1045\nREV. 12-3-37\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nQUESTIONNAIRES DESTROYED\nDear Red Cross Nurse:\nThe National Committee on Red Cross Nursing Service requires us to submit,\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,\nas we are extremely anxious to make a very complete report to National Headquarters.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nLucile M. Highy\nChairman or\nNurses should report at once to the\nSecretary.\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nOregon\nLocal Committee.\nthe address of the Secretary.\nName\nin\nfull LEPRESTRE - Generier\nIf married, give husband's name\nPermanent address 118 N. (STREET, W.22nd ETC.) Place (CITY) Portaned (COUNTY) multnowals, (STATE) oregon\nProbable address for the next year\nsame\n(STREET, ETC.)\nTelephone No. Be 8217\nPortteud (CITY) hultuomah (COUNTY) (STATE) organ\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nRene' Leprestre Father -\n0/00 Dorland International\nUnderline the type of work you are now doing:\nRockifeller\nR.C.A. Building\nkees\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? NO\nHave you ever been? NO -\nIndicate present physical condition good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. Yes\nBadge No. 62545\nCurrent date\n5-16-38-\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."
}