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Hines, Myrtle Nellie

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I 5 FORM 1045 REV. 1-2-35 1 Myr THE AMERICAN RED CROSS NATIONAL HEADQUARTERS typet WASHINGTON, D.C. N e 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 e 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 M. In order to render prompt service SECRETARY Chairman or in time of disaster, enrolled Red Cross MARYLAND STATE AND LOCAL COMMITTIO Secretary. Nurses should report at once to the RED CROSS NURBING SERVICE Secretary of the Local Committee under 433 N. LUZERNE AVE. Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full Hines, Myrtle Nellie If married, give husband's name Permanent address Frederick,Maryland. R.E.D.....4 (STREET, ETC.) (CITY) (COUNTY) (STATE) Probable address for the next year Maryland General Hospital (STREET ETC.) Telephone No. Vernon 0882 Baltimore Maryland (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) Cherles WaHines. Frederick Maryland, R.E.D.# 4 (Father) 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 of Red Cross classes in Home Hygiene and Care of the Sick? no Have you ever been? no Indicate present physical condition good Would you respond to an emergency call in event of epidemic, disaster, war, etc.? yes- Badge No. 2h386 Current date matel 31, 1934 8 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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Page
21
Source index
0
Type
photo
Media ID
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Size
unknown

Document data

ID
2661643
Core
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Type
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Context sent to Scholar

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    "ocrText": "I\n5\nFORM 1045\nREV. 1-2-35\n1\nMyr\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\ntypet\nWASHINGTON, D.C.\nN\ne\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\ne\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\nM.\nIn order to render prompt service\nSECRETARY\nChairman or\nin time of disaster, enrolled Red Cross\nMARYLAND STATE AND LOCAL COMMITTIO\nSecretary.\nNurses should report at once to the\nRED CROSS NURBING SERVICE\nSecretary of the Local Committee under\n433 N. LUZERNE AVE.\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full Hines, Myrtle Nellie\nIf married, give husband's name\nPermanent address\nFrederick,Maryland.\nR.E.D.....4\n(STREET, ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year Maryland General Hospital\n(STREET ETC.)\nTelephone No. Vernon 0882\nBaltimore\nMaryland\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)\nCherles WaHines. Frederick Maryland,\nR.E.D.# 4 (Father)\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 of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been?\nno\nIndicate present physical condition\ngood\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? yes-\nBadge No. 2h386\nCurrent date matel 31, 1934\n8\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."
}