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Mayo, Marion Kathleen

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FORM 1045 REV. 1-2-35 THE AMERICAN RED CROSS N NATIONAL HEADQUARTERS WASHINGTON, D.C. at 12 QUESTIONNAIRE DESTROYED Dear Madam: K 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 an 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 5 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: Yours sincerely, In order to render prompt service MISS E. V. INGLIS Chairman or in time of disaster, enrolled Red Cross VISITING.NUJRSE SERVICE Secretary. JOHN HANCOCK LIFE INS. co. Nurses should report at once to the P.O. BOX 111 Secretary of the Local Committee under BOSTON; MASS. Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full Maxian Kathleen May If married, give husband's name Permanent address Maye (STREET, Road KTC.) Wellesley (CITY) norfolk Massachustts above COUNTY) (STATE) Probable address for the next year Telephone No. Willerly 1786 (STREET ETC.) (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) Brother. John m. Mayo . 31 Parkn road Wellerley man Underline the type of work you are now doing: Army - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service - Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar. none 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 a Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? yes Badge No. Current date May 24, 1937 NOTE.-- 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. 5

Page data

Page
17
Source index
0
Type
photo
Media ID
8160f45e0d90a000
Size
unknown

Document data

ID
2661909
Core
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Type
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Context sent to Scholar

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    "coverageEndDate": {
        "day": 19,
        "logicalDate": "1944-01-19",
        "month": 1,
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Page context 
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    "ocrText": "FORM 1045\nREV. 1-2-35\nTHE AMERICAN RED CROSS\nN\nNATIONAL HEADQUARTERS\nWASHINGTON, D.C.\nat\n12\nQUESTIONNAIRE DESTROYED\nDear Madam:\nK\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\nan\ntherefore, please answer the following questions and return this form to me, in the\n+\nenclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED\n5\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:\nYours sincerely,\nIn order to render prompt service\nMISS E. V. INGLIS\nChairman or\nin time of disaster, enrolled Red Cross\nVISITING.NUJRSE SERVICE\nSecretary.\nJOHN HANCOCK LIFE INS. co.\nNurses should report at once to the\nP.O. BOX 111\nSecretary of the Local Committee under\nBOSTON; MASS.\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full Maxian Kathleen May\nIf married, give husband's name\nPermanent address Maye (STREET, Road KTC.) Wellesley (CITY) norfolk\nMassachustts\nabove\nCOUNTY)\n(STATE)\nProbable address for the next year\nTelephone No. Willerly 1786\n(STREET ETC.)\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)\nBrother. John m. Mayo . 31 Parkn road Wellerley man\nUnderline the type of work you are now doing:\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -\nPublic Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nnone\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\na\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ? yes\nBadge No.\nCurrent date May 24, 1937\nNOTE.-- 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.\n5"
}