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B
a
K
FORM 1045-B
THE AMERICAN RED CROSS
NATIONAL HEADQUARTERS
at
WASHINGTON, D.C.
JAN 8 1936
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all enrolled Red Cross Nurses with their latest addresses. We are
extremely anxious to make a very complete report and ask for your cooperation. Will
you kindly answer the following questions and return this form to me, in the enclosed
envelope, at the earliest possible date?
Yours sincerely,
Clasa D.
National Director,
Red Cross Nursing Service
Name in full BAKer Marie Therese
If married, give husband's name
Permanent address
204 hi fead Beda
Edmonton
Probable address for the next year
Alberta banade
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Dister m I m Cabe
Indicate
you are now
the doing: type of work as home
Are you of Red Cross classes in Home Hygiene and Care of the Sick?
an instructor ho
Have you ever been?
yes
Indicate present physical condition
good
Would respond emergency epidemic, disaster, war, ? yes.
you to an call in event of etc.
Badge No. 15533
Current date Gannary 13 3 6
W
W
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.
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"ocrText": "B\na\nK\nFORM 1045-B\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nat\nWASHINGTON, D.C.\nJAN 8 1936\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all enrolled Red Cross Nurses with their latest addresses. We are\nextremely anxious to make a very complete report and ask for your cooperation. Will\nyou kindly answer the following questions and return this form to me, in the enclosed\nenvelope, at the earliest possible date?\nYours sincerely,\nClasa D.\nNational Director,\nRed Cross Nursing Service\nName in full BAKer Marie Therese\nIf married, give husband's name\nPermanent address\n204 hi fead Beda\nEdmonton\nProbable address for the next year\nAlberta banade\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nDister m I m Cabe\nIndicate\nyou are now\nthe doing: type of work as home\nAre you of Red Cross classes in Home Hygiene and Care of the Sick?\nan instructor ho\nHave you ever been?\nyes\nIndicate present physical condition\ngood\nWould respond emergency epidemic, disaster, war, ? yes.\nyou to an call in event of etc.\nBadge No. 15533\nCurrent date Gannary 13 3 6\nW\nW\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."
}