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FORM 1045
AMERICAN RED CROSS
REV. DEC. 1939
NATIONAL HEADQUARTERS
QUESTIONNAIRES DESTROYED
WASHINGTON, D.C.
2 // /f
mcneil
Ella
Elizabeth
Name in full
(SURNAME)
(FIRST)
(MIDDLE)
Husband's name
715 S.Forest
annarbor
Washtenaw
mich
Permanent address
(STREET)
(CITY)
(COUNTY)
(STATE)
Probable address
for the next year
Same
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone number Q.G. 4121 Ext.690
(EXCHANGE)
(NO.)
Nearest relative or friend in United States, through whom you may be communicated with in
an emergency:
Mrs.a.0 Howard
mother
(NAME)
(RELATIONSHIP)
215 w Shawnee St
Tecumsen
micin
(STREET)
(CITY)
(STATE)
PRESENT WORK (check below)
Name of agency or institution with which employed
Institutional
Public Health
university of michigan
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 Excellent
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.
741276
Current
date march 19, 1940
Name of Committee MANHAITAN
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.
1
Page data
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- Source index
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- Type
- photo
- Media ID
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Document data
- ID
- 2661950
- Core
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- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "FORM 1045\nAMERICAN RED CROSS\nREV. DEC. 1939\nNATIONAL HEADQUARTERS\nQUESTIONNAIRES DESTROYED\nWASHINGTON, D.C.\n2 // /f\nmcneil\nElla\nElizabeth\nName in full\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\n715 S.Forest\nannarbor\nWashtenaw\nmich\nPermanent address\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address\nfor the next year\nSame\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number Q.G. 4121 Ext.690\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nMrs.a.0 Howard\nmother\n(NAME)\n(RELATIONSHIP)\n215 w Shawnee St\nTecumsen\nmicin\n(STREET)\n(CITY)\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nuniversity of michigan\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.\nyes\n(Granted of course that you could be released from present employment)\nPresent physical condition Excellent\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? no\nAre you a member of the American Nurses' Association? yes\nIf not, why have you allowed your membership to lapse?\nBadge No.\n741276\nCurrent\ndate march 19, 1940\nName of Committee MANHAITAN\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.\n1"
}