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Form 1045-Rev. 2-16-21 NATIONAL OFFICERS CENTRAL COMMITTEE HERBERT HOOVER, PRESIDENT JOHN BARTON PAYNE, CHAIRMAN CALVIN COOLIDGE, VICE PRESIDENT THE AMERICAN RED CROSS MRS. AUGUST BELMONT CHARLES EVANS HUGHES, VICE PRESIDENT CORNELIUS N. BLISS MABEL T. BOARDMAN THOMAS D. THACHER, COUNSELOR NATIONAL HEADQUARTERS WILLIAM R. CASTLE, JR. OGDEN L. MILLS, TREASURER MRS. HENRY P DAVISON MABEL T. BOARDMAN, SECRETARY WASHINGTON, D.C. MRS. FRANK v. HAMMAR SAMUEL KNIGHT OGDEN L. MILLS NATIONAL EXECUTIVE OFFICERS MAJ. GEN. ROBERT u. PATTERSON GUSTAVUS D. POPE JOHN BARTON PAYNE, CHAIRMAN MRS, HENRY R REA JAMES L. FIESER, VICE CHAIRMAN REAR ADMIRAL CHARLES E. RIGGS JOHN D. RYAN ERNEST P. BICKNELL, VICE CHAIRMAN GEORGE E. SCOTT JAMES K. McCLINTOCK, VICE CHAIRMAN HENRY UPSON SIMS 4/1/32 THOMAS D. THACHER ELIOT WADSWORTH Dear Madam: The National Committee on Red Cross Nursing Service requires us to submit, annually, a list of all the Red Cross Nurses enrolled with our Committee, with their latest addresses. We are extremely anxious to make a very complete report to National Headquarters and ask for your cooperation. Please answer the following questions and return this form to me, in enclosed envelope, at the eariest possible date. IMPORTANT: Yours sincerely, In order to render prompt service Chairmanoo in time of disaster, enrolled Red Cross K. C.Welch Secretary. Nurses should report at once to the Secretary of the Local Committee under MISS KATHARINE C. WELCH middleser Local Committee. which they are enrolled. Do not forget NEWTON HOSPITAL the address of the Secretary. NEWTON LOWER FALLS Name in full Yesabilla Gertrude Waters If married, give husband'e name Permanent address Lowill Road Groton middlessx massachualth (STREET, ETC.) (CITY) (COUNTY) (STATE) Probable address for the next year Same as above (STREET, ETC.) Telephone No. 265 Groton middless mass (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) Underline the Last type of work of you my are/now doing: family nonge-at home. Army - Navy - U.S.P.H. Service - U.S. Vet. 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 Fair Would you respond to an emergency call in event of epidemic, disaster, war, etc.? no. 70 years old Badge No. 34888 Current date June 1,1932 NOTE. If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrolment will be annulled.

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    "ocrText": "Form 1045-Rev. 2-16-21\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMRS. AUGUST BELMONT\nCHARLES EVANS HUGHES, VICE PRESIDENT\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nTHOMAS D. THACHER, COUNSELOR\nNATIONAL HEADQUARTERS\nWILLIAM R. CASTLE, JR.\nOGDEN L. MILLS, TREASURER\nMRS. HENRY P DAVISON\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nSAMUEL KNIGHT\nOGDEN L. MILLS\nNATIONAL EXECUTIVE OFFICERS\nMAJ. GEN. ROBERT u. PATTERSON\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE, CHAIRMAN\nMRS, HENRY R REA\nJAMES L. FIESER, VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nERNEST P. BICKNELL, VICE CHAIRMAN\nGEORGE E. SCOTT\nJAMES K. McCLINTOCK, VICE CHAIRMAN\nHENRY UPSON SIMS\n4/1/32\nTHOMAS D. THACHER\nELIOT WADSWORTH\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the eariest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nChairmanoo\nin time of disaster, enrolled Red Cross\nK. C.Welch Secretary.\nNurses should report at once to the\nSecretary of the Local Committee under\nMISS KATHARINE C. WELCH\nmiddleser\nLocal Committee.\nwhich they are enrolled. Do not forget\nNEWTON HOSPITAL\nthe address of the Secretary.\nNEWTON LOWER FALLS\nName in full\nYesabilla Gertrude Waters\nIf married, give husband'e name\nPermanent address Lowill Road\nGroton middlessx massachualth\n(STREET, ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year\nSame as above\n(STREET, ETC.)\nTelephone No. 265\nGroton middless mass\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)\nUnderline the Last type of work of you my are/now doing: family nonge-at home.\nArmy - Navy - U.S.P.H. Service - U.S. Vet. Administration - U.S. Indian Service\n-\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 Fair\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? no. 70 years\nold\nBadge No. 34888\nCurrent date June 1,1932\nNOTE. If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
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