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Name in full
MARGARET AGNES STACK
9 DESTROYED
If married, give husband's name
Permanent address
49 STATE STREET WINDSOR VERMONT
(CITY)
(COUNTY)
(STATE)
(STREET, ETC.)
Probable address for next year 271WHITNEY AVENUE
(STREET, ETC.)
NEW HAVEN
CONN
Telephone No.
(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)
MOTHER: MRS MARY STACK WINDSOR VERMONT) MRS J.G
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.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No
Have you ever been? YES
Indicate present physical condition EXCELLENT
Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? YES
Badge No. 28379
Current date April 14 1937.
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.
Page data
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- 5
- Source index
- 0
- Type
- photo
- Media ID
- 40e5a8f74cd50598
- Size
- unknown
Document data
- ID
- 2662297
- Core
- doc
- Type
- document
DTO data
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Document source extras
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Page context
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"ocrText": "Name in full\nMARGARET AGNES STACK\n9 DESTROYED\nIf married, give husband's name\nPermanent address\n49 STATE STREET WINDSOR VERMONT\n(CITY)\n(COUNTY)\n(STATE)\n(STREET, ETC.)\nProbable address for next year 271WHITNEY AVENUE\n(STREET, ETC.)\nNEW HAVEN\nCONN\nTelephone No.\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)\nMOTHER: MRS MARY STACK WINDSOR VERMONT) MRS J.G\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.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No\nHave you ever been? YES\nIndicate present physical condition EXCELLENT\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ? YES\nBadge No. 28379\nCurrent date April 14 1937.\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."
}