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FORM 1045
REV. JAN 1941
AMERICAN RED CROSS
NATIONAL HEADQUARTERS
WASHINGTON. D.C.
Name in full Schlesinger Stefania
Year of Birth 1898
(SURNAME)
(FIRST)
(MIDDLE)
Husband's name
Permanent address 129 Prospect (STREET) Place So (CITY) Orange
Essex
n.J.
(COUNTY)
(STATE)
Probable address
for the next yearl 129 Prospect (STREET) Place So (CITY) (Orange
Essey
n.J.
(COUNTY)
(STATE)
Telephone number
So
2
9156
(EXCHANGE)
(NO.)
Give name and address of nearest relative or friend in United States:
Mrs L7 Bird
friend
(NAME)
(RELATIONSHIP)
129 Prospect Place (ADDRESS) So Grange h J.
PRESENT EMPLOYMENT (check below)
Name of agency or institution with which employed
Institutional
after Aprill-1941
Public Health
Bubics' Hospital Coit Memorial
Private duty
15 Roseville Ave
Other (write in)
Newark n.J.
Government Service: Army
U.S.P.H. Service
Veterans Administration
Navy
U.S. Indian Service
Children's Bureau
MAJOR RESPONSIBILITIES Adminis-
Super-
Teach-
General
Private
Other
of present employment tration
vision
ing
Staff
Duty
(specify)
IF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:
Institutional
Public Health
Private duty
Other
(WRITE IN)
AVAILABILITY
At the present time would you
Date not for y in
accept assignment to the Army? Yes
No
Navy? Yes
No
available April 19412
In case of a war emergency would you
accept assignment to the Army? Yes
No
Navy? Yes
No
If not now employed would you
accept nursing work? Full-time? Yes
No
Part-time? Yes
No
In your own community? Yes
No
Elsewhere? Yes
No
Would you be interested in teaching classes in Home Hygiene and Care of the Sick? Unable now
Present physical condition
Excellent
Badge No. H.D.2224
Name of Committee
Newark Local n.J.
Current date March 3-1941
SC
Note: If a nurse does not complete and return this questionnaire, and cannot be located
within two years, her enrollment will be removed from our active files.
Page data
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- Source index
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- Media ID
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Document data
- ID
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- Core
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- Type
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DTO data
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"ocrText": "FORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON. D.C.\nName in full Schlesinger Stefania\nYear of Birth 1898\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent address 129 Prospect (STREET) Place So (CITY) Orange\nEssex\nn.J.\n(COUNTY)\n(STATE)\nProbable address\nfor the next yearl 129 Prospect (STREET) Place So (CITY) (Orange\nEssey\nn.J.\n(COUNTY)\n(STATE)\nTelephone number\nSo\n2\n9156\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\nMrs L7 Bird\nfriend\n(NAME)\n(RELATIONSHIP)\n129 Prospect Place (ADDRESS) So Grange h J.\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nafter Aprill-1941\nPublic Health\nBubics' Hospital Coit Memorial\nPrivate duty\n15 Roseville Ave\nOther (write in)\nNewark n.J.\nGovernment Service: Army\nU.S.P.H. Service\nVeterans Administration\nNavy\nU.S. Indian Service\nChildren's Bureau\nMAJOR RESPONSIBILITIES Adminis-\nSuper-\nTeach-\nGeneral\nPrivate\nOther\nof present employment tration\nvision\ning\nStaff\nDuty\n(specify)\nIF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther\n(WRITE IN)\nAVAILABILITY\nAt the present time would you\nDate not for y in\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable April 19412\nIn case of a war emergency would you\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\nIf not now employed would you\naccept nursing work? Full-time? Yes\nNo\nPart-time? Yes\nNo\nIn your own community? Yes\nNo\nElsewhere? Yes\nNo\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? Unable now\nPresent physical condition\nExcellent\nBadge No. H.D.2224\nName of Committee\nNewark Local n.J.\nCurrent date March 3-1941\nSC\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enrollment will be removed from our active files."
}