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B us FORM 1045 REV. 4-4-38 THE AMERICAN RED CROSS NATIONAL HEADQUARTERS WASHINGTON, D. c. G e Dear Red Cross Nurse: T The National Committee on Red Cross Nursing Service requires us to submit, annually, a report of all the Red Cross Nurses enrolled with our Committee. Will you therefore, please answer the following questions and return this form to me, in the enclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED WITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec- ognize the value of filing this information and will return the questionnaire promptly, as we are extremely anxious to make a very complete report to National Headquarters. IMPORTANT: Yours sincerely, In order to render prompt service Chairman or in time of disaster, enrolled Red Cross MARIE RYAN Secretary. Nurses should report at once to the Secretary of the Local Committee under 2246 N. 4th St. Columhus Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full Sarah gentrude Bush If married, give husband's name 132 E. ComoAve Columbus Frankling ohio Permanent address (STREET. ETC.) (CITY) (COUNTY) (STATE) Probable address for the next year same (STREET, ETC.) Telephone No. La688 Columbus Franklin ohio (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 mas Ella P. Bush. Same sbove 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 - Private Duty - Industrial - Office Nurse - Registrar. Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no Have you ever been? yes Would you like to teach Red Cross classes? good 20, Indicate present physical condition Would you respond to an emergency call in event of epidemic, disaster, war, etc.? Badge No. 20,614 Current date april- 17,1939 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\nus\nFORM 1045\nREV. 4-4-38\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. c.\nG\ne\nDear Red Cross Nurse:\nT\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a report of all the Red Cross Nurses enrolled with our Committee. Will you\ntherefore, please answer the following questions and return this form to me, in the\nenclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED\nWITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-\nognize the value of filing this information and will return the questionnaire promptly,\nas we are extremely anxious to make a very complete report to National Headquarters.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nChairman or\nin time of disaster, enrolled Red Cross\nMARIE RYAN\nSecretary.\nNurses should report at once to the\nSecretary of the Local Committee under\n2246 N. 4th St.\nColumhus\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full\nSarah gentrude Bush\nIf married, give husband's name\n132 E. ComoAve Columbus Frankling ohio\nPermanent address\n(STREET. ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year\nsame\n(STREET, ETC.)\nTelephone No. La688\nColumbus\nFranklin\nohio\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 mas Ella P. Bush. Same sbove\nUnderline the type of work you are now doing:\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -\nPublic Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been? yes Would you like\nto teach Red Cross classes?\ngood\n20,\nIndicate present physical condition\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. 20,614\nCurrent date april- 17,1939\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."
}