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Commins, Mary Petronilla

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FORM 1045 REV. JAN 1941 AMERICAN RED CROSS NATIONAL HEADQUARTERS is WASHINGTON, D. c. Name in full Commins (SURNAME) mary (FIRST) Petronilla (MIDDLE) Year of Birth 1905 - M Husband's name Permanent address C/o midweatin (STREET) area (CITY) i R.C. (COUNTY) St Louis 7 mo (STATE) as Probable address for the next year Detroit (STREET) V. h. (CITY) A. Detroit michagin from Sept, 1540) (COUNTY) (STATE) Telephone number (EXCHANGE) (NO.) Give name and address of nearest relative or friend in United States: (NAME) J. Frank Commins D.V.D. brother 176 Bruadway Smith Boston, mas (RELATIONSHIP) (ADDRESS) PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Public Health Finney C. Chapter Q. R.C. Kansha Private duty Other (write in) Government Service: Army U.S.P.H. Service Veterans Administration Navy U.S.Indian Service Children's Bureau (P.H.N.) 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 (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? you Present physical condition (CK Badge No. 69426 Current date 3-17-40 Name of Committee Tapikay Kansas, Lacal Committee Note: If a nurse does not complete and return this questionnaire, and cannot be located 2 within two years, her enrollment will be removed from our active files.

Page data

Page
38
Source index
0
Type
photo
Media ID
1ee26cc89d92097f
Size
unknown

Document data

ID
2661265
Core
doc
Type
document
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Context sent to Scholar

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    "ocrText": "FORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nis\nWASHINGTON, D. c.\nName\nin full Commins (SURNAME) mary (FIRST) Petronilla (MIDDLE) Year of Birth\n1905 -\nM\nHusband's name\nPermanent address C/o midweatin (STREET) area (CITY) i R.C. (COUNTY) St Louis 7 mo (STATE)\nas\nProbable address\nfor the next year Detroit (STREET) V. h. (CITY) A. Detroit michagin from Sept, 1540)\n(COUNTY)\n(STATE)\nTelephone number\n(EXCHANGE)\n(NO.)\nGive name and address of nearest relative or friend in United States:\n(NAME)\nJ. Frank Commins D.V.D. brother 176 Bruadway Smith Boston, mas\n(RELATIONSHIP)\n(ADDRESS)\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nFinney C. Chapter Q. R.C. Kansha\nPrivate duty\nOther (write in)\nGovernment Service: Army\nU.S.P.H. Service\nVeterans Administration\nNavy\nU.S.Indian Service\nChildren's Bureau\n(P.H.N.)\nMAJOR RESPONSIBILITIES Adminis-\nSuper-\nTeach\nGeneral\nPrivate\nOther\nof present employment\ntration\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\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? you\nPresent physical condition\n(CK\nBadge No.\n69426\nCurrent date\n3-17-40\nName of Committee Tapikay Kansas, Lacal Committee\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\n2\nwithin two years, her enrollment will be removed from our active files."
}