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A.R.C. MAIL ROOM RECEIVED 10 DESTROYED QUESTIONNAIRES evil APR FORM 104340 REVIDEO 1939 AMERICAN RED CROSS Referred to NATIONAL HEADQUARTERS WASHINGTON, D. C. APR 18 1940 Name in full Schladweiler. Rosa Marie (SURNAME) (FIRST) (MIDDLE) Husband's name Permanent address Box III Madison Lac Qui Parle Minnesota (STREET) (CITY) (COUNTY) (STATE) Probable address for the next year I709 Washington Ave; St. Louis St. Louis Missouri (STREET) (CITY) (COUNTY) (STATE) Telephone number - Can't recall this number (EXCHANGE) (NO.) Nearest relative or friend in United States, through whom you may be communicated with in an emergency: Miss Margaret Schladweiler: Sister (NAME) (RELATIONSHIP) Box II7 Madison Minnesota (STREET) (CITY) (STATE) PRESENT WORK (check below) Name of agency or institution with which employed Institutional Public Health X Nursing Consultant, American National Red Cross Midwestern Branch Private duty Other (write in) 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. Yes (Granted of course that you could be released from present employment) Present physical condition Excellent Would you be interested in teaching classes in Home Hygiene and Care of the Sick? Are you a member of the American Nurses' Association? Yes If not, why have you allowed your membership to lapse? Badge No. 49,263 Current date April 22, I940 NATIONAL HEADQUARTERS Name of Committee Note: If a nurse does not complete and return this questionnaire, and cannot be located within two years, her enroilment Will be removed from our active files.

Page data

Page
26
Source index
0
Type
photo
Media ID
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Size
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Document data

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2662227
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Document identity
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Document source extras
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Page context
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    "ocrText": "A.R.C. MAIL ROOM\nRECEIVED\n10 DESTROYED\nQUESTIONNAIRES\nevil\nAPR FORM 104340\nREVIDEO 1939\nAMERICAN RED CROSS\nReferred to\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nAPR 18 1940\nName in full\nSchladweiler.\nRosa\nMarie\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent address Box III\nMadison\nLac Qui Parle\nMinnesota\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address\nfor the next year I709 Washington Ave; St. Louis\nSt. Louis\nMissouri\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone\nnumber - Can't recall this number\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nMiss Margaret Schladweiler:\nSister\n(NAME)\n(RELATIONSHIP)\nBox II7\nMadison\nMinnesota\n(STREET)\n(CITY)\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nX\nNursing Consultant, American National Red Cross\nMidwestern Branch\nPrivate duty\nOther (write in)\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, flood, war, etc.\nYes\n(Granted of course that you could be released from present employment)\nPresent physical condition Excellent\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick?\nAre you a member of the American Nurses' Association?\nYes\nIf not, why have you allowed your membership to lapse?\nBadge No. 49,263\nCurrent date April 22, I940\nNATIONAL HEADQUARTERS\nName of Committee\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enroilment Will be removed from our active files."
}