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ORIGINAL
Form No. 200
Revised 5-15-18-3M-9-13-18 P. B.
vd
asvissist
lle
to
AMERICAN RED CROSS
belloms
old
SERVICE APPLICATION FORM
Annyo
amb
Applicants for Nursing and Medical Service must accompany this form with special forms supplied by the Nursing Service and the Medical Service Bureaus
of the American Red Cross.
These questions must be answered fully or the application will not be acted upon.
VAS
Tedmom
Date april
I. Name in full Gertrude Elisabet mill
Telephone 08 H No. Glendale 738R.
2. Permanent Address c/o Hermann.R. mill 2316 Western Ave Seattle, Wash
(Number and Street)
(City)
(State)
3.
Temporary Address, if any, to what date 195-Cass Ave, BOY
795Cass Ave
Indiatrologingment
(Number and Street)
(City)
4. (a) If any. changes of residence since August I, 1914, give these in full with dates. 1416 Washing for the to5-1-18.
michigan
(State)
materloicLawre, 795 Cass are Detroit mich from 5-3-18 Previous that 509 chicagoIll Honore Str
(b) What is your present business or profession? Visiting nurse
11-11-13to 1-4-17
Name of firm or corporation with which associated Detroit visiting nurses assm
Duration of Service Eleven months
Business Address 924 Brush Str.
Detroit,
Present Capacity. Baby milk Fund nurse
(Number and Street)
(City)
michlgan
(State)
5. Date of Birth 1883 (Year) June (Month) (Day) 22 (a) Place of Birth Chicago, donst l llinois
(b) If of foreign birth, when and where did you arrive in the United States?
6. If foreign born, give date and court of your naturalization
7. (a) Single, married or widower Single
(a) Number of dependents none
(b) Full name of wife before marriage; or husband
(c) Birthplace of wife or husband
Nationality of wife or husband
(d) Birthplace and nationality of father of wife or husband
(e) Birthplace and nationality of mother of wife or husband
(f) Full name of father Hermanny Richard mill
(g) Birthplace and nationality of father Germany naturalized United States
Citizen
(h) If father foreign born, whether naturalized,
when and where Chicago, Illinois U.S.A.
(2) Full maiden name of mother Lydie Herrmann
30yrs ago
(j)
Birthplace and nationality of mother
(k) If mother foreign born, whether naturalized, when and where? Chicago, Illinois U. La
(1) Full name and nationality of paternal grandfather Friedrich mill- German
(m) Full maiden name and nationality of paternal grandmother amman
(n) Full name and nationality of maternal grandfather Gottlieb Herrmann German
(o) Full maiden name and nationality of maternal grandmother Caroline Elisabet Lander
German
8. (a) What previous business or professional experience have you had, stating nature, places and principal dates
thereof; the names of the firms or corporations with which you were associated Private duty from
1-4-17 to 11-1-17th.n a. duty at Waterloo, Iowa 11-1-17to 3-1-18
Private v.n.a. duty at 3-1-18 Detroit, to 5-1-18at michigan 5-3-18 to" present date.
Page data
- Page
- 123
- Source index
- 0
- Type
- photo
- Media ID
- 952a6409ed33ba95
- Size
- unknown
Document data
- ID
- 2661971
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source metadata
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Document source extras
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"url": "https://catalog.archives.gov/id/2661971",
"naId": 2661971,
"coverageEndDate": {
"day": 27,
"logicalDate": "1944-09-27",
"month": 9,
"year": 1944
},
"coverageStartDate": {
"day": 24,
"logicalDate": "1918-05-24",
"month": 5,
"year": 1918
},
"levelOfDescription": "fileUnit",
"onlineResources": [
{
"description": "Ancestry Collection: 2365",
"note": "This file was scanned as part of a collaboration effort between Ancestry and the National Archives.",
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Page context
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"ocrText": "ORIGINAL\nForm No. 200\nRevised 5-15-18-3M-9-13-18 P. B.\nvd\nasvissist\nlle\nto\nAMERICAN RED CROSS\nbelloms\nold\nSERVICE APPLICATION FORM\nAnnyo\namb\nApplicants for Nursing and Medical Service must accompany this form with special forms supplied by the Nursing Service and the Medical Service Bureaus\nof the American Red Cross.\nThese questions must be answered fully or the application will not be acted upon.\nVAS\nTedmom\nDate april\nI. Name in full Gertrude Elisabet mill\nTelephone 08 H No. Glendale 738R.\n2. Permanent Address c/o Hermann.R. mill 2316 Western Ave Seattle, Wash\n(Number and Street)\n(City)\n(State)\n3.\nTemporary Address, if any, to what date 195-Cass Ave, BOY\n795Cass Ave\nIndiatrologingment\n(Number and Street)\n(City)\n4. (a) If any. changes of residence since August I, 1914, give these in full with dates. 1416 Washing for the to5-1-18.\nmichigan\n(State)\nmaterloicLawre, 795 Cass are Detroit mich from 5-3-18 Previous that 509 chicagoIll Honore Str\n(b) What is your present business or profession? Visiting nurse\n11-11-13to 1-4-17\nName of firm or corporation with which associated Detroit visiting nurses assm\nDuration of Service Eleven months\nBusiness Address 924 Brush Str.\nDetroit,\nPresent Capacity. Baby milk Fund nurse\n(Number and Street)\n(City)\nmichlgan\n(State)\n5. Date of Birth 1883 (Year) June (Month) (Day) 22 (a) Place of Birth Chicago, donst l llinois\n(b) If of foreign birth, when and where did you arrive in the United States?\n6. If foreign born, give date and court of your naturalization\n7. (a) Single, married or widower Single\n(a) Number of dependents none\n(b) Full name of wife before marriage; or husband\n(c) Birthplace of wife or husband\nNationality of wife or husband\n(d) Birthplace and nationality of father of wife or husband\n(e) Birthplace and nationality of mother of wife or husband\n(f) Full name of father Hermanny Richard mill\n(g) Birthplace and nationality of father Germany naturalized United States\nCitizen\n(h) If father foreign born, whether naturalized,\nwhen and where Chicago, Illinois U.S.A.\n(2) Full maiden name of mother Lydie Herrmann\n30yrs ago\n(j)\nBirthplace and nationality of mother\n(k) If mother foreign born, whether naturalized, when and where? Chicago, Illinois U. La\n(1) Full name and nationality of paternal grandfather Friedrich mill- German\n(m) Full maiden name and nationality of paternal grandmother amman\n(n) Full name and nationality of maternal grandfather Gottlieb Herrmann German\n(o) Full maiden name and nationality of maternal grandmother Caroline Elisabet Lander\nGerman\n8. (a) What previous business or professional experience have you had, stating nature, places and principal dates\nthereof; the names of the firms or corporations with which you were associated Private duty from\n1-4-17 to 11-1-17th.n a. duty at Waterloo, Iowa 11-1-17to 3-1-18\nPrivate v.n.a. duty at 3-1-18 Detroit, to 5-1-18at michigan 5-3-18 to\" present date."
}