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B
a
K
ect
ARC. Care
RECI
AMERICAN RED CROSS
FEB
0.0.1940
FORM 1045
Baker
REV. DEC. 1939
MAR19 1940
NATIONAL HEADQUARTERS
WASHINGTON, D.C.
Beth
Name in full
Bahron havi
There
(SURNAME)
(FIRST)
(MIDDLE)
Husband's name
Baker Jermyn
Osear
Permanent address
9917 - 116 St Edwonton alberta
(STREET)
(CITY)
(COUNTY)
Probable address
(STATE) Gauary
for the next year
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone number
24137
Edmonter
S
(EXCHANGE)
(NO.)
Nearest relative or friend in United States, through whom you may be communicated with in
an emergency:
m Im Cabe
Jester
(NAME)
(RELATIONSHIP)
(STREET)
317 were (CITY) 4581 newyorkly (STATE)
PRESENT WORK (check below)
Name of agency or institution with which employed
Institutional,
Public Health
Private duty
Other (write in)
at home
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.
tyes
(Granted of course that you could be released from present employment)
Good
Present physical condition
Would you be interested in teaching classes in Home Hygiene and Care of the Sick? yes
Are you a member of the American Nurses' Association?
no
If not, why have you allowed your membership to lapse? in Canade
Badge No. 15533
Current date march 141940
Name of Committee
NATIONAL HEADOUARTERS
W
W
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.
Page data
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- Source index
- 0
- Type
- photo
- Media ID
- dc5c918f0dc3c0dc
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Document data
- ID
- 2661070
- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "B\na\nK\nect\nARC. Care\nRECI\nAMERICAN RED CROSS\nFEB\n0.0.1940\nFORM 1045\nBaker\nREV. DEC. 1939\nMAR19 1940\nNATIONAL HEADQUARTERS\nWASHINGTON, D.C.\nBeth\nName in full\nBahron havi\nThere\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nBaker Jermyn\nOsear\nPermanent address\n9917 - 116 St Edwonton alberta\n(STREET)\n(CITY)\n(COUNTY)\nProbable address\n(STATE) Gauary\nfor the next year\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\n24137\nEdmonter\nS\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nm Im Cabe\nJester\n(NAME)\n(RELATIONSHIP)\n(STREET)\n317 were (CITY) 4581 newyorkly (STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional,\nPublic Health\nPrivate duty\nOther (write in)\nat home\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.\ntyes\n(Granted of course that you could be released from present employment)\nGood\nPresent physical condition\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? yes\nAre you a member of the American Nurses' Association?\nno\nIf not, why have you allowed your membership to lapse? in Canade\nBadge No. 15533\nCurrent date march 141940\nName of Committee\nNATIONAL HEADOUARTERS\nW\nW\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."
}