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H.D. June21, 1940. FORM 1045 AMERICAN RED CROSS REV. DEC. 1939 NATIONAL HEADQUARTERS Referrod to WASHINGTON. D.C. Name in full Laxton Ruth (SURNAME) (FIRST) (MIDDLE) Husband's name Moravian Falls, Wilkes North Carolina Permanent address (STREET) (CITY) (COUNTY) (STATE) Probable address co Rutherford County Health Department, Murfreesboro Rutherford Tenn. for the next year (STREET) (CITY) (COUNTY) (STATE) 1271 Telephone number (EXCHANGE) (NO.) Nearest relative or friend in United States, through whom you may be communicated with in an emergency: Mrs. W. A Laxton Mother (NAME) (RELATIONSHIP) Moravian Falls North Carolia (STREET) (CITY) (STATE) PRESENT WORK (check below) Name of agency or institution with which employed Institutional (Rutherford County Health Department and Public Health (State..Teachers.!..College, Murfreesboro, Tenn- 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, flood, war, etc. Yes (Granted of course that you could be released from present employment) Present physical condition Good Yes Would you be interested in teaching classes in Home Hygiene and Care of the Sick? I Are you a member of the American Nurses' Association? Yes If not, why have you allowed your membership to lapse? D. Badge No. Home Defense Current date October 30, 1940 Name of Committee I am not working with a committee at the present time U 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. 2

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39
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Page context
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    "ocrText": "H.D.\nJune21, 1940.\nFORM 1045\nAMERICAN RED CROSS\nREV. DEC. 1939\nNATIONAL HEADQUARTERS\nReferrod to\nWASHINGTON. D.C.\nName in full\nLaxton\nRuth\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nMoravian Falls,\nWilkes\nNorth Carolina\nPermanent address\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address\nco\nRutherford County Health Department, Murfreesboro\nRutherford\nTenn.\nfor the next year\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\n1271\nTelephone number\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nMrs. W. A Laxton\nMother\n(NAME)\n(RELATIONSHIP)\nMoravian Falls North Carolia\n(STREET)\n(CITY)\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\n(Rutherford County Health Department and\nPublic Health\n(State..Teachers.!..College, Murfreesboro, Tenn-\nPrivate duty\nOther (write in)\nGovernment Service: Army\nU.S.P.H.Service\nVeterans Administration\nNavy\nU.S.Indian Service\nChildren's Bureau\nIF\nNOT 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 as\nepidemic, flood, war, etc.\nYes\n(Granted of course that you could be released from present employment)\nPresent physical condition\nGood\nYes\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick?\nI\nAre you a member of the American Nurses' Association?\nYes\nIf not, why have you allowed your membership to lapse?\nD.\nBadge No. Home Defense\nCurrent date October 30, 1940\nName of Committee I am not working with a committee at the present time\nU\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.\n2"
}