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Gray, Sara M.

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FORM 1045 THE AMERICAN RED CROSS REV. 1-2-35 NATIONAL HEADQUARTERS WASHINGTON, D. C. Dear Madam: 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: In order to render prompt service Yours sincerely, in time of disaster, enrolled Red Cross Chairman or FLORENCE M. JOHNSON Nurses should report at once to the Secretary. MANHATTAN Secretary of the Local Committee under which they are enrolled. Do not forget Local Committee. the address of the Secretary. Name in full Sara In Gray If married, give husband's name Permanent address 632E5 (STREET, ETC.) It. (CITY) n.y Cig : (COUNTY) (STATE) Probable address for the next year Same (STREET, ETC.) Telephone No. Why block 4. .3109 (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) Mrs m Wainwright Blethewood Comm. (Sister) 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. Social Service no Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? Have no you ever been? Indicate Fair present physical condition Would you respond to an emergency call in event of epidemic, disaster, war, etc.? yes Badge No. fost Current date april 16- 1937 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.

Page data

Page
9
Source index
0
Type
photo
Media ID
7f0f0b2eef0374f5
Size
unknown

Document data

ID
2661552
Core
doc
Type
document
DTO data 
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Context sent to Scholar

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Document source extras 
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    "url": "https://catalog.archives.gov/id/2661552",
    "naId": 2661552,
    "coverageEndDate": {
        "day": 27,
        "logicalDate": "1942-01-27",
        "month": 1,
        "year": 1942
    },
    "coverageStartDate": {
        "day": 4,
        "logicalDate": "1918-06-04",
        "month": 6,
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    },
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Page context 
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    "ocrText": "FORM 1045\nTHE AMERICAN RED CROSS\nREV. 1-2-35\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nDear Madam:\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:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nChairman or\nFLORENCE M. JOHNSON\nNurses should report at once to the\nSecretary.\nMANHATTAN\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nLocal Committee.\nthe address of the Secretary.\nName in full Sara In Gray\nIf married, give husband's name\nPermanent address 632E5 (STREET, ETC.) It. (CITY) n.y Cig : (COUNTY)\n(STATE)\nProbable address for the next year\nSame\n(STREET, ETC.)\nTelephone No. Why block 4. .3109\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)\nMrs m Wainwright Blethewood Comm. (Sister)\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.\nSocial Service\nno\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?\nHave no\nyou ever been?\nIndicate Fair\npresent physical condition\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nyes\nBadge No. fost\nCurrent date april 16- 1937\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."
}