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5
5
FORM 1045
REV. JAN 1941
AMERICAN RED CROSS
NATIONAL HEADQUARTERS
I
WASHINGTON, D.C.
1941
Name in full
Bunting
Hilda
of Birth 1882
-
(SURNAME)
(FIRST)
*M
D
Husband's
name Bunting Frederic
2001 Bloor N. Tororto
Benry 1941
a
Referte Antonio
Canada
Permanent address
(STREET)
(CITY)
(COUNTY)
(STATE)
C.
for Probable the next address year 2001 Bloor W.
Cauada
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone
number Junction (EXCHANGE) 9023 (NO.)
Give, name and address of nearest relative or friend in United States:
Jean (NAME) m. but
niece
(RELATIONSHIP)
65 Eugone (ADDRESS) are Buffalo usth ny
PRESENT EMPLOYMENT (check below)
Name of agency or institution with which employed
Institutional
Public Health
Private duty
Other (write in)
Government Service: Army
U.S.P.H. Service
Veterans Administration
Navy
U.S.Indian Service
Children's Bureau
MAJOR ESPONSIBILITIES Adminis
Super
Teach
General
Private
Other
of present employment tration
vision
ing
Staff
Duty
(specify)
IF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:
Institutional
Public Health
Private duty
Other
(WRITE IN)
AVAILABILITY
At the present time would you
Date
accept assignment to the Army? Yes
No
Navy? Yes
No
available
In case of a war emergency would you
accept assignment to the Army? Yes
No
Navy? Yes
No
If not now employed would you
accept nursing work? Full-time? Yes
No
Part-time? Yes
No
In your own community? Yes
No
Elsewhere? Yes
No
-
Would you be interested in teaching classes in Home Hygiene and Care of the Sick?
5
Present physical condition Under Doctor care Diabetic + Heart Condetion
W
Badge No. 15362. of unable to do work of any kind
6
Current date
a
NATONALCHEADEUARTERS
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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- Source index
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- Type
- photo
- Media ID
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Document data
- ID
- 2661183
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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Page context
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"ocrText": "B\na\n5\n5\nFORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nI\nWASHINGTON, D.C.\n1941\nName in full\nBunting\nHilda\nof Birth 1882\n-\n(SURNAME)\n(FIRST)\n*M\nD\nHusband's\nname Bunting Frederic\n2001 Bloor N. Tororto\nBenry 1941\na\nReferte Antonio\nCanada\nPermanent address\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nC.\nfor Probable the next address year 2001 Bloor W.\nCauada\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone\nnumber Junction (EXCHANGE) 9023 (NO.)\nGive, name and address of nearest relative or friend in United States:\nJean (NAME) m. but\nniece\n(RELATIONSHIP)\n65 Eugone (ADDRESS) are Buffalo usth ny\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nPrivate duty\nOther (write in)\nGovernment Service: Army\nU.S.P.H. Service\nVeterans Administration\nNavy\nU.S.Indian Service\nChildren's Bureau\nMAJOR ESPONSIBILITIES Adminis\nSuper\nTeach\nGeneral\nPrivate\nOther\nof present employment tration\nvision\ning\nStaff\nDuty\n(specify)\nIF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther\n(WRITE IN)\nAVAILABILITY\nAt the present time would you\nDate\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable\nIn case of a war emergency would you\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\nIf not now employed would you\naccept nursing work? Full-time? Yes\nNo\nPart-time? Yes\nNo\nIn your own community? Yes\nNo\nElsewhere? Yes\nNo\n-\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick?\n5\nPresent physical condition Under Doctor care Diabetic + Heart Condetion\nW\nBadge No. 15362. of unable to do work of any kind\n6\nCurrent date\na\nNATONALCHEADEUARTERS\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."
}