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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."
}