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FORM 1045.A
30281
REV. OCT,1938
AMERICAN RED CROSS
NATIONAL HEADQUARTERS
WASHINGTON, D.C.
A.R.C. MAIL ROOM
RECEIVED
January 18, 1939
JAN2E 1939
Referred to mus
5
Dear Red Cross Nurse:
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,
IMPORTANT:
In order to render prompt service
in time of disaster, enrolled Red Cross
Nurses should report at once to the
Mary Beard
Secretary of the Local Committee under
which they are enrolled. Do not forget
Director, Nursing Service
the address of the Secretary.
Name in full
LINNIE BEAuchAMp
If married, give husband's name
- SINgle
Permanent address 2106NIVAN BURENST. Little Rock. PulAski
AnKANSAS
(STREET, ETC,)
(CITY)
(COUNTY)
(STATE)
Probable address for the next year 1020MyRTlest ERIE PA.
OFFICE 26-705
(STREET, ETC.)
Telephone No.
(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)
MoThER MRS MAMIEIA BEAUCHAMP- 2106 N VANDUREN St. Little Rock, ARK.
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 - Priyate Duty - Industrial - Office Nurse - Registrar.
INSTRUCTOR - HOME HygiENE , And CARE of the Sick_ ERIE ChAptER- REd CROSS.
Have you ever been?
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? yes
Indicate present physical condition Good
Would you respond to an emergency call in event of epidemic, disaster, war, etc.? yes
3
Badge No. 30-281
Current date 1721-1939
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.
8
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"ocrText": "FORM 1045.A\n30281\nREV. OCT,1938\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D.C.\nA.R.C. MAIL ROOM\nRECEIVED\nJanuary 18, 1939\nJAN2E 1939\nReferred to mus\n5\nDear Red Cross Nurse:\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,\nIMPORTANT:\nIn order to render prompt service\nin time of disaster, enrolled Red Cross\nNurses should report at once to the\nMary Beard\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nDirector, Nursing Service\nthe address of the Secretary.\nName in full\nLINNIE BEAuchAMp\nIf married, give husband's name\n- SINgle\nPermanent address 2106NIVAN BURENST. Little Rock. PulAski\nAnKANSAS\n(STREET, ETC,)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year 1020MyRTlest ERIE PA.\nOFFICE 26-705\n(STREET, ETC.)\nTelephone No.\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)\nMoThER MRS MAMIEIA BEAUCHAMP- 2106 N VANDUREN St. Little Rock, ARK.\nUnderline the type of work you are now doing:\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service\n-\nPublic Health - Institutional - Priyate Duty - Industrial - Office Nurse - Registrar.\nINSTRUCTOR - HOME HygiENE , And CARE of the Sick_ ERIE ChAptER- REd CROSS.\nHave you ever been?\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? yes\nIndicate present physical condition Good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? yes\n3\nBadge No. 30-281\nCurrent date 1721-1939\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.\n8"
}