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F
C
9-2
K
FORM 1045
REV. DEC. 1939
J.
AMERICAN RED CROSS
NATIONAL HEADQUARTERS
a
WASHINGTON, D.C.
Name in full
towle
Juliana
(SURNAME)
(FIRST)
Thompson (MIDDLE) Kuqua
Husband's name
towle, Frederick E
Permanent address
2919 Que Wash.
D.C.
(STREET)
(CITY)
(COUNTY)
(STATE)
Probable address
for the next year
Same
S.
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone number Dupont
7322
(EXCHANGE)
(NO.)
Nearest relative or friend in United States, through whom you may be communicated with in
an emergency:
mrs. alfred Harper
Sister
(NAME)
Redhake Falls (RELATIONSHIP)
minnesota
Mrs.
(STREET)
(CITY)
(STATE)
PRESENT WORK (check below)
Name of agency or institution with which employed
Institutional
E
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
IF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar:
Institutional
Public Health
Private duty
Other (write in)
Would you respond to an emergency call in event of local or national emergency, such
as
epidemic, (Granted flood, war, of etc. not you at present be released from -illness present employment) in travely
course that could/
Present physical condition Good.
Would you be interested in teaching classes in Home Hygiene and Care of the Sick? Notat prosent
Are you a member of the American Nurses' Association? yes.
If not, why have you allowed your membership to lapse?
Badge No. 9304
Current
date 7eb.19,1940
Name of Committee DIST. OF COLUMBIA
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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- Type
- photo
- Media ID
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Document data
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- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "F\nC\n9-2\nK\nFORM 1045\nREV. DEC. 1939\nJ.\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\na\nWASHINGTON, D.C.\nName in full\ntowle\nJuliana\n(SURNAME)\n(FIRST)\nThompson (MIDDLE) Kuqua\nHusband's name\ntowle, Frederick E\nPermanent address\n2919 Que Wash.\nD.C.\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address\nfor the next year\nSame\nS.\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number Dupont\n7322\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nmrs. alfred Harper\nSister\n(NAME)\nRedhake Falls (RELATIONSHIP)\nminnesota\nMrs.\n(STREET)\n(CITY)\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\nE\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\nIF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther (write in)\nWould you respond to an emergency call in event of local or national emergency, such\nas\nepidemic, (Granted flood, war, of etc. not you at present be released from -illness present employment) in travely\ncourse that could/\nPresent physical condition Good.\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? Notat prosent\nAre you a member of the American Nurses' Association? yes.\nIf not, why have you allowed your membership to lapse?\nBadge No. 9304\nCurrent\ndate 7eb.19,1940\nName of Committee DIST. OF COLUMBIA\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."
}