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FORM 1045
REV. 4-4-38
THE AMERICAN RED CROSS
NATIONAL HEADQUARTERS
WASHINGTON, D. C.
25 DESTROYED
M
Dear Red Cross Nurse:
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
Nurses should report at once to the
mary L Nawlhome
Secretary.
Secretary of the Local Committee under
DIST, OF COLUMBIA
which they are enrolled. Do not forget
Local Committee.
the address of the Secretary.
Name in full
Ruth marion martin
If married, give husband's name
Permanent
address 2760 (STREET. Devonshire ETC.) Ph.N.W. (CITY) Shoshington (COUNTY) J.C
(STATE)
Probable address for the next year Same
(STREET. ETC.)
Telephone No. Columbia 1586
Same
(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)
Underline the type of work you are now doing:
mis Hehen m. Brothey (Friend) Devonshire Th.N.W. - City
Army - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -
Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No.
Have you ever been? No.
Would you like to teach Red Cross classes? yes
Indicate present physical condition good
Would respond emergency call in of epidemic, disaster, war, yes
you to an event etc. ?
Badge No. 61517
Current date 2-26-39
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.
9
J
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"ocrText": "M\nar\n+:\ns\nFORM 1045\nREV. 4-4-38\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\n25 DESTROYED\nM\nDear Red Cross Nurse:\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\nNurses should report at once to the\nmary L Nawlhome\nSecretary.\nSecretary of the Local Committee under\nDIST, OF COLUMBIA\nwhich they are enrolled. Do not forget\nLocal Committee.\nthe address of the Secretary.\nName in full\nRuth marion martin\nIf married, give husband's name\nPermanent\naddress 2760 (STREET. Devonshire ETC.) Ph.N.W. (CITY) Shoshington (COUNTY) J.C\n(STATE)\nProbable address for the next year Same\n(STREET. ETC.)\nTelephone No. Columbia 1586\nSame\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)\nUnderline the type of work you are now doing:\nmis Hehen m. Brothey (Friend) Devonshire Th.N.W. - City\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -\nPublic Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No.\nHave you ever been? No.\nWould you like to teach Red Cross classes? yes\nIndicate present physical condition good\nWould respond emergency call in of epidemic, disaster, war, yes\nyou to an event etc. ?\nBadge No. 61517\nCurrent date 2-26-39\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.\n9\nJ"
}