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FORM 1045 REV. 2-16-31 NATIONAL OFFICERS CENTRAL COMMITTEE HERBERT HOOVER, PRESIDENT JOHN BARTON PAYNE, CHAIRMAN ROBERT w. DE FOREST, VICE PRESIDENT MRS. AUGUST BELMONT CALVIN COOLIDGE, VICE PRESIDENT THE AMERICAN RED CROSS CORNELIUS N. BLISS MABEL T. BOARDMAN CHARLES EVANS HUGHES. VICE PRESIDENT JOSEPH P. COTTON THOMAS D. THACHER, COUNSELOR NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON OGDEN L. MILLS, TREASURER MRS. FRANK v. HAMMAR MABEL T. BOARDMAN, SECRETARY WASHINGTON, D.C. MAJ. GEN. M. w. IRELAND SAMUEL KNIGHT OGDEN L. MILLS GUSTAVUS D. POPE NATIONAL EXECUTIVE OFFICERS MRS. HENRY R. REA JOHN BARTON PAYNE, CHAIRMAN REAR ADMIRAL CHARLES E. RIGGS JOHN D. RYAN JAMES L. FIESER, VICE CHAIRMAN GEORGE E. SCOTT ERNEST P. BICKNELL, VICE CHAIRMAN HENRY UPSON SIMS JAMES K. Mcclintock, VICE CHAIRMAN THOMAS D. THACHER ELIOT WADSWORTH 9 7 QUESTIONNAIRES D2STROYEL e Dear Madam: The National Committee on Red Cross Nursing Service requires us to submit, annually, a list of all the Red Cross Nurses enrolled with our Committee, with their latest addresses. We are extremely anxious to make a very complete report to National Headquarters and ask for your cooperation. Please answer the following questions and return this form to me, in enclosed envelope, at the earliest possible date. IMPORTANT: In order to render prompt service Mattering Yours sincerely, in time of disaster, enrolled Red Cross Chairman- or Nurses should report at once to the Secretary. Secretary of the Local Committee under which they are enrolled. Do not forget Talrdo Ohio the address of the Secretary. 285.3 Parkwood Local Committee. Name in full Sarah Gertrude Bush If married, give husband's name Permanent address 4106 STREET, sfc. Kingsbury Toledo Lucas Ohio CITY COUNTY STATE Probable address for the next year 1903 monroe St Telephone No. La 3417 STREET, ETC. Toledo Luces ohio Ma 4201 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) Underline the type of work Mrs. Ella Bush same address (mother) you are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - 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? Have you ever been? yes Indicate present physical condition good 20 Would you respond to an emergency call in event of epidemic, disaster, war, etc.: yes Badge No. 20614 Current date april 3rd 1936 6 NOTE.--If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrolment will be annulled.

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    "ocrText": "FORM 1045 REV. 2-16-31\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT w. DE FOREST, VICE PRESIDENT\nMRS. AUGUST BELMONT\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nCHARLES EVANS HUGHES. VICE PRESIDENT\nJOSEPH P. COTTON\nTHOMAS D. THACHER, COUNSELOR\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nOGDEN L. MILLS, TREASURER\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nOGDEN L. MILLS\nGUSTAVUS D. POPE\nNATIONAL EXECUTIVE OFFICERS\nMRS. HENRY R. REA\nJOHN BARTON PAYNE, CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nJAMES L. FIESER, VICE CHAIRMAN\nGEORGE E. SCOTT\nERNEST P. BICKNELL, VICE CHAIRMAN\nHENRY UPSON SIMS\nJAMES K. Mcclintock, VICE CHAIRMAN\nTHOMAS D. THACHER\nELIOT WADSWORTH\n9\n7 QUESTIONNAIRES D2STROYEL\ne\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the earliest possible date.\nIMPORTANT:\nIn order to render prompt service\nMattering\nYours sincerely,\nin time of disaster, enrolled Red Cross\nChairman- or\nNurses should report at once to the\nSecretary.\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nTalrdo Ohio\nthe address of the Secretary.\n285.3 Parkwood\nLocal Committee.\nName in full\nSarah Gertrude Bush\nIf married, give husband's name\nPermanent address 4106 STREET, sfc.\nKingsbury\nToledo\nLucas\nOhio\nCITY\nCOUNTY\nSTATE\nProbable address for the next year\n1903 monroe St\nTelephone No. La 3417\nSTREET, ETC.\nToledo\nLuces\nohio\nMa 4201\nCITY\nCOUNTY\nSTATE\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nUnderline the type of work\nMrs. Ella Bush same address (mother)\nyou are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - U.S. Indian\nService - Public Health - Institutional - Private Duty - Industrial - Office Nurse -\nRegistrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?\nHave you ever been?\nyes\nIndicate present physical condition\ngood\n20\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.: yes\nBadge No. 20614\nCurrent date april 3rd 1936\n6\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
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