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a
e
T
FORM 1045
REV. 4-4-38
THE AMERICAN RED CROSS
NATIONAL HEADQUARTERS
WASHINGTON, D.C.
Mrs
rs.
B
Dear Red Cross Nurse
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a report of all the Red Cross Nurses enrolled with our Committee. Will
therefore, please answer the following questions and return this form to me, in the you
enclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED
WITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-
ognize the value of filing this information and will return the questionnaire promptly,
as we are extremely anxious to make a very complete report to National Headquarters.
C
IMPORTANT:
In order to render prompt service
Yours sincerely,
in time of disaster, enrolled Red Cross
Chairman or
S
Nurses should report at once to the
PLORENCE M. JOHNSON
Secretary.
Secretary of the Local Committee under
+
the
MANHATTAN
which they are enrolled. Do not forget
Local Committee.
e
the address of the Secretary.
-
Name in full mrs. Byrtene C, Anderson
o
If married, give husband's name
-
Permanent address Odyssey cruses one, 366 madison air. new york of
(STREET. ETC.)
(CITY)
(COUNTY)
(STATE)
Probable address for the next year same
(STREET, ETC.)
Telephone No mu 2-1183
(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)
mr. W. E. Castello, clay Center Kansas
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? no
Would you like to teach Red Cross classes? no
Indicate present physical condition Excellent
Would you respond to an emergency call in event of epidemic, disaster, war, etc.? yes
Badge 20380
No.
Current date march 6,1939
D
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.
W
Sorry teans remember number of badge - is in safets deforest
8
box - something like 20180,
O
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"ocrText": "D\n5\na\ne\nT\nFORM 1045\nREV. 4-4-38\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D.C.\nMrs\nrs.\nB\nDear Red Cross Nurse\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a report of all the Red Cross Nurses enrolled with our Committee. Will\ntherefore, please answer the following questions and return this form to me, in the you\nenclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED\nWITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-\nognize the value of filing this information and will return the questionnaire promptly,\nas we are extremely anxious to make a very complete report to National Headquarters.\nC\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nChairman or\nS\nNurses should report at once to the\nPLORENCE M. JOHNSON\nSecretary.\nSecretary of the Local Committee under\n+\nthe\nMANHATTAN\nwhich they are enrolled. Do not forget\nLocal Committee.\ne\nthe address of the Secretary.\n-\nName in full mrs. Byrtene C, Anderson\no\nIf married, give husband's name\n-\nPermanent address Odyssey cruses one, 366 madison air. new york of\n(STREET. ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year same\n(STREET, ETC.)\nTelephone No mu 2-1183\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)\nmr. W. E. Castello, clay Center Kansas\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? no\nWould you like to teach Red Cross classes? no\nIndicate present physical condition Excellent\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? yes\nBadge 20380\nNo.\nCurrent date march 6,1939\nD\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.\nW\nSorry teans remember number of badge - is in safets deforest\n8\nbox - something like 20180,\nO"
}