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Mrs.
FORM 1045
AMERICAN RED CROSS
REV. DEC. 1939
NATIONAL HEADQUARTERS
WASHINGTON, D. C.
Name in full
Weaver
ablie
Roberts
(SURNAME)
(FIRST)
heaver
(MIDDLE)
Husband's name
Charles P.
to
Permanent address BW275A7- (STREET) Bonte I - - (CITY) Sungree - bobb (COUNTY)
Georgia
(STATE)
Probable address
for the next year
Same as above
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone number
none
(EXCHANGE)
(NO.)
Nearest relative or friend in United States, through whom you may be communicated with in
an emergency:
charles P.Meaver
husband
(NAME)
(RELATIONSHIP)
Same as above
(STREET)
(CITY)
(STATE)
PRESENT WORK (Check below)
Name of agency or institution with which employed
Institutional
Public Health
Georgia repartment of Public Health
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.
(Granted of course that you could be released from present employment)
Present physical condition
Would Hygiene and Care of the Sick? hot at present
good
you be interested in teaching classes in Home
Are you a member of the American Nurses' Association?
yes
If not, why have you allowed your membership to lapse?
Badge No.
Current date march 29, 1940
Name of Committee
altauta -Georgia
Note: If a nurse does not complete and return this questionnaire, and cannot be located
within two years, her enrollment will be removed from our active files.
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- Type
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Document data
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- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "Mrs.\nFORM 1045\nAMERICAN RED CROSS\nREV. DEC. 1939\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nName in full\nWeaver\nablie\nRoberts\n(SURNAME)\n(FIRST)\nheaver\n(MIDDLE)\nHusband's name\nCharles P.\nto\nPermanent address BW275A7- (STREET) Bonte I - - (CITY) Sungree - bobb (COUNTY)\nGeorgia\n(STATE)\nProbable address\nfor the next year\nSame as above\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone number\nnone\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\ncharles P.Meaver\nhusband\n(NAME)\n(RELATIONSHIP)\nSame as above\n(STREET)\n(CITY)\n(STATE)\nPRESENT WORK (Check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nGeorgia repartment of Public Health\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.\n(Granted of course that you could be released from present employment)\nPresent physical condition\nWould Hygiene and Care of the Sick? hot at present\ngood\nyou be interested in teaching classes in Home\nAre you a member of the American Nurses' Association?\nyes\nIf not, why have you allowed your membership to lapse?\nBadge No.\nCurrent date march 29, 1940\nName of Committee\naltauta -Georgia\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enrollment will be removed from our active files."
}