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0 M FORM 1045 REV. 12-3-37 THE AMERICAN RED CROSS NATIONAL HEADQUARTERS WASHINGTON, D. C. D 5 12 5 BESTROYED 0 Dear Red Cross Nurse: a 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 is 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 AVIS F. FRINK Chairman or Nurses should report at once to the Secretary. Secretary of the Local Committee under SAN FRANCISCO, CALIF. which they are enrolled. Do not forget Local Committee. the address of the Secretary. Name in full o'malley, anne Louis If married, give husband's name - Single Permanent address 746 geary Saul (CITY) -rancisco (COUNTY) S.F California TATE) (STREET, ETC.) Probable address for the next year Isame as above (STREET, ETC.) Telephone No. Prospect 5016 (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: malley (states) 746 geary start, Santrancisco Army - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service - (cleir mann Health: - office, au - 1- rancisco - - el 0480 Public Institutional Privata Duty Industrial office Murse - Registrar. Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no. Have you ever been? ho Indicate present physical condition Excellent Would you respond to an emergency call in event of epidemic, disaster, war, etc.? you 63 of Badge No. 17,586 Current date April 4.1928 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": "0\nM\nFORM 1045\nREV. 12-3-37\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nD\n5\n12\n5\nBESTROYED\n0\nDear Red Cross Nurse:\na\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\nis\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\nAVIS F. FRINK\nChairman or\nNurses should report at once to the\nSecretary.\nSecretary of the Local Committee under\nSAN FRANCISCO, CALIF.\nwhich they are enrolled. Do not forget\nLocal Committee.\nthe address of the Secretary.\nName in full o'malley, anne Louis\nIf married, give husband's name - Single\nPermanent address 746 geary Saul (CITY) -rancisco (COUNTY) S.F California TATE)\n(STREET, ETC.)\nProbable address for the next year\nIsame as above\n(STREET, ETC.)\nTelephone No. Prospect 5016\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:\nmalley (states) 746 geary start, Santrancisco\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -\n(cleir mann Health: - office, au - 1- rancisco - - el 0480\nPublic Institutional Privata Duty Industrial office Murse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no.\nHave you ever been? ho\nIndicate present physical condition Excellent\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? you\n63\nof\nBadge No. 17,586\nCurrent date April 4.1928\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."
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