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San
M
lurph
T
Fr
5
Fran
TO
FORM 1045
REV. 1-2-35
THE AMERICAN RED CROSS
and
D
NATIONAL HEADQUARTERS
=
WASHINGTON, D. c.
Mary
<
DESTROYED
Dear Madam:
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
to
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:
Yours sincerely,
In order to render prompt service
AVIS F. FRINK
Chairman or
in time of disaster, enrolled Red Cross
SHRINERS HOGPITAL
Secretary.
Nurses should report at once to the
SAN FRANCISCO, CALIF.
Secretary of the Local Committee under
Local Committee.
which they are enrolled. Do not forget
the address of the Secretary.
Name in full Murphy alice V.
smif married, give husband's name
-
sao
hase
Permanent address 580McAHister (STREET, (CITY) California (COUNTY)
ETC.)
(STATE)
Probable address for the next year Same as above
(STREET ETC.)
Telephone No. MK 7942
(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)
M. E. fviis (Friend) 580 me allister Sh. San Fancisco, Cal:
Underline the type of work you are now doing:
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 and
of Red Cross classes in Home Hygiene Care of the Sick? No
Have you ever been?
No
Indicate present physical condition very good
Would you respond to an emergency call in event of epidemic, disaster, war, etc.
Badge No. 400 17931
Current for
62
date april 8,1938
yrs
?
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.
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"ocrText": "San\nM\nlurph\nT\nFr\n5\nFran\nTO\nFORM 1045\nREV. 1-2-35\nTHE AMERICAN RED CROSS\nand\nD\nNATIONAL HEADQUARTERS\n=\nWASHINGTON, D. c.\nMary\n<\nDESTROYED\nDear Madam:\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\nto\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:\nYours sincerely,\nIn order to render prompt service\nAVIS F. FRINK\nChairman or\nin time of disaster, enrolled Red Cross\nSHRINERS HOGPITAL\nSecretary.\nNurses should report at once to the\nSAN FRANCISCO, CALIF.\nSecretary of the Local Committee under\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full Murphy alice V.\nsmif married, give husband's name\n-\nsao\nhase\nPermanent address 580McAHister (STREET, (CITY) California (COUNTY)\nETC.)\n(STATE)\nProbable address for the next year Same as above\n(STREET ETC.)\nTelephone No. MK 7942\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)\nM. E. fviis (Friend) 580 me allister Sh. San Fancisco, Cal:\nUnderline the type of work you are now doing:\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 and\nof Red Cross classes in Home Hygiene Care of the Sick? No\nHave you ever been?\nNo\nIndicate present physical condition very good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.\nBadge No. 400 17931\nCurrent for\n62\ndate april 8,1938\nyrs\n?\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."
}