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5-1
FORM 1045
AMERICAN RED CROSS
REV. DEC.1939
NATIONAL HEADQUARTERS
WASHINGTON, D.C.
martin
Name in full
Ruth
marion
(SURNAME)
(FIRST)
(MIDDLE)
Husband's name
Permanent
address 2760 (STREET) Devonshire (CITY) Th. .N.W. hashington (COUNTY) D.C. (STATE)
Probable address
Same
for the next year
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone number
Columbia
1586
(EXCHANGE)
(NO.)
Nearest relative or friend in United States, through whom you may be communicated with in
an emergency:
mrs Frank HUNT
Sister
(NAME)
(RELATIONSHIP)
1439- Behmont (STREET) St. N.W.
Chashington, (CITY) J.C.
(STATE)
PRESENT WORK (check below)
Name of agency or institution with which employed
Institutional
Emergency Hospitah
Public Health
Mashington, D.C.
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.
(Granted of course that you could be released from present employment)
yes
Present physical condition Good
Would you be interested in teaching classes in Home Hygiene and Care of the Sick? No
Are
you a member of the American Nurses' Association? yes
If not, why have you allowed your membership to lapse?
Badge No. 61517
Current
date march 17. 1940
DIST, of COLUMBIA
Name of Committee
Note: If a nurse does not complete and return this questionnaire, and cannot be located
within two years, her enroilment will be removed from our active files.
9
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- Type
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Document data
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"ocrText": "M\n5-1\nFORM 1045\nAMERICAN RED CROSS\nREV. DEC.1939\nNATIONAL HEADQUARTERS\nWASHINGTON, D.C.\nmartin\nName in full\nRuth\nmarion\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent\naddress 2760 (STREET) Devonshire (CITY) Th. .N.W. hashington (COUNTY) D.C. (STATE)\nProbable address\nSame\nfor the next year\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\nColumbia\n1586\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nmrs Frank HUNT\nSister\n(NAME)\n(RELATIONSHIP)\n1439- Behmont (STREET) St. N.W.\nChashington, (CITY) J.C.\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\nEmergency Hospitah\nPublic Health\nMashington, D.C.\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 as\nepidemic, flood, war, etc.\n(Granted of course that you could be released from present employment)\nyes\nPresent physical condition Good\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? No\nAre\nyou a member of the American Nurses' Association? yes\nIf not, why have you allowed your membership to lapse?\nBadge No. 61517\nCurrent\ndate march 17. 1940\nDIST, of COLUMBIA\nName of Committee\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enroilment will be removed from our active files.\n9"
}