General Register of Applicants for Relief, Food Station No. ....
San Francisco, 1906
==================+==============================+======+==============
Surname and | Total number of persons for | Food | Date
given names of | whom rations are asked: .... | Card | of this
head of family: | | No. | registration:
| Men .... Children .... | |
| Women .... Aged, etc. .... | |
------------------+------------------------------+------+--------------
Present location: | Former home, or address on April 17:
|
------------------+-------+---------------+------------+---------------
Trade or | Age: | Nationality: | Union: | Former
occupation of | | | | employer:
head of family: | | | |
| | | |
------------------+-------+---------------+------------+---------------
References, or other memoranda relating to employment:
-----------------------------------------------------------------------
Membership in (1) fraternal orders; (2) churches; (3) clubs:
-----------------------------------------------------------------------
Address of friends to be communicated with:
--------------------+---------------+----------------------------------
Present employment: | Is it steady? | Is applicant owner of real
| | estate? If so, where?
| |
--------------------+---------------+----------------------------------
Plans for future:
-----------------------------------------------------------------------
Relief supplied (other than rations, including transportation):
-----------------------------------------------------------------------
Remarks:
Food Card Issued.
-----+-----------------------------------------------------------------
No. | Date.
-----+-----------------------------------------------------------------
|
|
|
===============================================================
Data as to adult bread winners in family or party (not the
applicant named on face of card).
---------------------------------------------------------------
|_m._ _f._|_m._ _f._|_m._ _f._|_m._ _f._
-----------------------+---------+---------+---------+---------
Name and sex | | | |
-----------------------+---------+---------+---------+---------
Age and nationality | | | |
-----------------------+---------+---------+---------+---------
Trade or occupation | | | |
-----------------------+---------+---------+---------+---------
Union | | | |
-----------------------+---------+---------+---------+---------
Former employer | | | |
-----------------------+---------+---------+---------+---------
References | | | |
-----------------------+---------+---------+---------+---------
Present employment | | | |
-----------------------+---------+---------+---------+---------
Future plans | | | |
-----------------------+---------+---------+---------+---------
Remarks:
1 | NATIONAL RED CROSS. |
----+ |
2 | FOOD CARD. |
----+ |
3 | +--------+ |
----+ | | |
4 | | | |
----+ | | |
5 | +--------+ |
----+ |
6 | C. No. ......... R. S. No. .............. | (See other side.)
----+ |
7 | This card is issued on.................... |
----+ (date) |
8 | |
----+ |
9 | It will be good for 10 days ending........ | 31
----+ (date) +----
10 | | 30
----+ +----
11 | ......................................... | 29
----+ (Signature of Issuing Officer.) +----
12 | | 28
----+--+--+--+--+--+--+--+--+--+--+--+--+--+--+--+----
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