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e _c Revised May 20, 1918. # 22788 L Top Sheet Upper portion for Eivisional Record. Also see last portion of application Mrs form. cto O L Recommended by Northern Division for enrollment under Requisition Nurse If not American citizen, so state, and give citizenship Scotch a Is applicant available leaving home two weeks from date full papers are rec'd in Nashington Yes Name Street Address Anno Forbos Roid IV. P. Hospital, 3 City Missoula, Montana Temporary Address to what date Please check or fill out blanks where possible Languages spoken (Location of Proposed length of stay Duration of war E-Excellent Service desired Full Vo lunteer No -Good F-Fair Volunteer with expenses met by Red Cross No Is allowance for living abroad to be left to discretion of foreign Commission? Yes Allowance for living abroad if not left to discretion of foreign Commission? salary over expense allowance if any$70 a month Allowance for living prior to departure Yes Requisition for uniform and equipment Yes Allowance for transportation overseas and re- turn Yes Allowance for transportation in U.S.and return Yes Physical Report Age 27 Loyalty investigation conducted by (Name of agency Date examined Date Reported employed, if any) None August 1918 and Report Aug.30,1918 "A" List of Loyalty indorsements: H. B. Smith, Pres. N.P.B.A..St. Paul, Minn. H. R. Boden, Chief clerk, Supt. office, Rocky Nit. Division, N. ..Bailway Co., Missoula, Mont. Helen M. Cass, Suptl of Nurses, N. P. Hospital, Missoula, Mont. Harry H. Parsens, Missoula, Mont. Have passport application and oictures been forwarded No Date Headquarters Record (Initial, date, and "o.K." where acceptable) File Record Date Referred to Classification Full papers Provisional Enrollment a War Dept. 9/12/18 of Physical Actual Enrollment Remarks

Page data

Page
47
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0
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Size
unknown

Document data

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2662087
Core
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Type
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DTO data
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Document identity
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Document source extras
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        "month": 2,
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Page context
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    "ocrText": "e\n_c\nRevised May 20, 1918.\n#\n22788\nL\nTop Sheet\nUpper portion for Eivisional Record. Also see last portion of application\nMrs\nform.\ncto\nO\nL\nRecommended by Northern Division for enrollment under Requisition Nurse\nIf not American citizen, so state, and give citizenship Scotch\na\nIs applicant available leaving home two weeks from date full papers are rec'd in\nNashington Yes\nName\nStreet Address\nAnno Forbos Roid\nIV. P. Hospital,\n3\nCity Missoula, Montana\nTemporary Address to what date\nPlease check or fill out blanks where possible\nLanguages spoken\n(Location of\nProposed length of stay Duration of war\nE-Excellent\nService desired\nFull Vo lunteer\nNo\n-Good F-Fair\nVolunteer with expenses met by Red Cross No\nIs allowance for living abroad to be left to\ndiscretion of foreign Commission? Yes\nAllowance for living abroad if not left to\ndiscretion of foreign Commission?\nsalary over expense allowance if any$70 a month\nAllowance for living prior to departure Yes\nRequisition for uniform and equipment Yes\nAllowance for transportation overseas and re-\nturn\nYes\nAllowance for transportation in U.S.and return\nYes\nPhysical Report\nAge 27\nLoyalty investigation conducted by (Name of agency\nDate examined\nDate Reported\nemployed, if any)\nNone\nAugust 1918\nand Report\nAug.30,1918\n\"A\"\nList of Loyalty indorsements:\nH. B. Smith, Pres. N.P.B.A..St. Paul, Minn. H. R. Boden, Chief clerk, Supt. office,\nRocky Nit. Division, N. ..Bailway Co., Missoula, Mont. Helen M. Cass, Suptl of Nurses,\nN. P. Hospital, Missoula, Mont. Harry H. Parsens, Missoula, Mont.\nHave passport application and oictures been forwarded No\nDate\nHeadquarters Record (Initial, date, and \"o.K.\" where acceptable)\nFile Record\nDate\nReferred to\nClassification\nFull papers\nProvisional Enrollment\na\nWar Dept. 9/12/18\nof\nPhysical\nActual Enrollment\nRemarks"
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