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N A.R.C. MAIL ROOM RECEIV FBB 20 1940 FORM 1045 AMERICAN RED CROSS REV. DEC. 1939 OUESTIONNAIRES DESTROYES NATIONAL HEADQUARTERS APR 1 8 1940 WASHINGTON, D. C. Refexrod to. Name in full Muni Christine mercedes S (SURNAME) (FIRST) (MIDDLE) e Husband s name Permanent address 134 (STREET) East 1914St (CITY) newyork (COUNTY) City (STATE) n.y Probable for the next address year Alunker (STREET) College of hursing Tokyo (COUNTY), Japan (STATE) Telephone number (EXCHANGE) (NO.) Nearest relative or friend in United States, through whom you may be communicated with in (Miss) Florence Johnson an emergency: Friend (NAME) 134 (STREET) East 19th St new (CITY) your City (STATE) n.y. PRESENT WORK (check below) Name of agency or institution with which employed - Institutional National Council Episcopal Church Public Health Director P.H. nursing Shukes Tokyo Japas 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? yes. Are you a member of the American Nurses' Association? yes g If not, why have you allowed your membership to lapse? J Badge No. 33922 Current date March 281940 NATIONAL MEADQUARTERS 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.

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    "ocrText": "N\nA.R.C. MAIL ROOM\nRECEIV FBB 20 1940\nFORM 1045\nAMERICAN RED CROSS\nREV. DEC. 1939\nOUESTIONNAIRES DESTROYES\nNATIONAL HEADQUARTERS APR 1 8 1940\nWASHINGTON, D. C. Refexrod to.\nName in full\nMuni\nChristine\nmercedes\nS\n(SURNAME)\n(FIRST)\n(MIDDLE)\ne\nHusband s name\nPermanent\naddress 134 (STREET) East 1914St (CITY) newyork (COUNTY) City (STATE) n.y\nProbable\nfor the\nnext address year Alunker (STREET) College of hursing Tokyo (COUNTY), Japan (STATE)\nTelephone number\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\n(Miss) Florence Johnson\nan emergency:\nFriend\n(NAME)\n134 (STREET) East 19th St new (CITY) your City (STATE) n.y.\nPRESENT WORK (check below)\nName of agency or institution with which employed\n-\nInstitutional\nNational Council Episcopal Church\nPublic Health\nDirector P.H. nursing Shukes Tokyo Japas\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\nExcellent.\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick? yes.\nAre you a member of the American Nurses' Association?\nyes\ng\nIf not, why have you allowed your membership to lapse?\nJ\nBadge No. 33922\nCurrent date March 281940\nNATIONAL MEADQUARTERS\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."
}