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FORM 1045 REV. JAN 1941 AMERICAN RED CROSS NATIONAL HEADQUARTERS WASHINGTON, D. C. Butler Ida F Name in full Year of Birth 1868 (SURNAME) (FIRST) (MIDDLE) Husband's name Permanent address 7 South (STREET) Highland (CITY) St West Hariford (COUNTY) (STATE) Come Probable address for the next year The Same (STREET) (CITY) (COUNTY) (STATE) Telephone number 3-0641 (EXCHANGE) (NO.) Give name and address of nearest relative or friend in United States: M. Sames 9. Butter 204 Us. Quaker Lane Unst Hurefina (NAME) (RELATIONSHIP) (ADDRESS) Come PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Hm Retired 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 RESPONSIBILITIES 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 Administration (WRITE IN) AVAILABILITY Run Cross none At the present time would you not Eligible 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 be interested no you in teaching classes in Home Hygiene and Care of the Sick? Present physical condition long ford Badge No. 248 Current date Name of Committee Hariford Committee Ishany 2771 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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    "ocrText": "FORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nButler\nIda\nF\nName in full\nYear of Birth 1868\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent\naddress 7 South (STREET) Highland (CITY) St West Hariford (COUNTY) (STATE) Come\nProbable address\nfor the next year\nThe Same\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\n3-0641\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\nM. Sames\n9. Butter 204 Us. Quaker Lane Unst Hurefina\n(NAME)\n(RELATIONSHIP)\n(ADDRESS)\nCome\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nHm Retired\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 RESPONSIBILITIES 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 Administration\n(WRITE IN)\nAVAILABILITY\nRun Cross none\nAt the present time would you\nnot Eligible\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\nWould be interested no\nyou in teaching classes in Home Hygiene and Care of the Sick?\nPresent physical condition long ford\nBadge No. 248\nCurrent date\nName of Committee Hariford Committee\nIshany 2771\nNote:\nIf 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."
}