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SECOND RESERVE
FORM 1045
AMERICAN RED CROSS
REV. DEC. 1939
NATIONAL HEADQUARTERS
WASHINGTON, D.C.
Name in full Quer
Ursula
Tibbele
Carl (SURNAME) L.
(FIRST)
(MIDDLE)
Husband's name
Permanent address 3113.E65 (STREET) Seattle (CITY) King (COUNTY) Wash (STATE)
for the next year 31139.65
Probable address
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone
number Kenwood 5323
(EXCHANGE)
(NO.)
S
Nearest relative or friend in United States, through whom you may be communicated with in
an emergency:
Over Carl L
husband
(NAME)
(RELATIONSHIP)
3113&-65
Seattle
Wast
(STREET)
(CITY)
(STATE)
PRESENT WORK (check below)
Name of agency or institution with which employed
Institutional
Public Health
V american Red Cross Clinic for School
children
Private duty
Other (write in)
Government Service: Army
U.S.P.H.Service
Veterans Administration
Navy
U.S.Indian Service
Children's Bureau
IF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar:
Institutional
Public Health
Private duty
Other (write in)
Would you respond to an emergency call in event of local or national emergency, such as
epidemic, flood, war, etc. no
(Granted of course that you could be released from present employment)
Present physical condition fair
Would you be interested in teaching classes in Home Hygiene and Care of the Sick?
Are you a member of the American Nurses' Association? no
If not, why have you allowed your membership to lapse' samot a Efford it
5
Badge No. 19511
SEC. RED CROSS COMM.
Current date april 1,1940
Name of Committee
sm
SEATTLE
WASH.
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.
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"ocrText": "N\nA\nu\nSECOND RESERVE\nFORM 1045\nAMERICAN RED CROSS\nREV. DEC. 1939\nNATIONAL HEADQUARTERS\nWASHINGTON, D.C.\nName in full Quer\nUrsula\nTibbele\nCarl (SURNAME) L.\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent address 3113.E65 (STREET) Seattle (CITY) King (COUNTY) Wash (STATE)\nfor the next year 31139.65\nProbable address\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone\nnumber Kenwood 5323\n(EXCHANGE)\n(NO.)\nS\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nOver Carl L\nhusband\n(NAME)\n(RELATIONSHIP)\n3113&-65\nSeattle\nWast\n(STREET)\n(CITY)\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nV american Red Cross Clinic for School\nchildren\nPrivate duty\nOther (write in)\nGovernment Service: Army\nU.S.P.H.Service\nVeterans Administration\nNavy\nU.S.Indian Service\nChildren's Bureau\nIF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther (write in)\nWould you respond to an emergency call in event of local or national emergency, such as\nepidemic, flood, war, etc. no\n(Granted of course that you could be released from present employment)\nPresent physical condition fair\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick?\nAre you a member of the American Nurses' Association? no\nIf not, why have you allowed your membership to lapse' samot a Efford it\n5\nBadge No. 19511\nSEC. RED CROSS COMM.\nCurrent date april 1,1940\nName of Committee\nsm\nSEATTLE\nWASH.\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."
}