Patient #2587 of JCRS.
Found in 1 Collection or Record:
Abstract Application for admittance to JCRS filled out by hand in ink for Ethel Tuberman. Information on the form includes her age, birth place, occupation, residence, marital status, and nearest relatives, and is signed by Ethel Tuberman. Beside the signature is a note that reads "Will bring address as soon as she moves N.J.H." At the bottom of the page, under "Recommendation" there is a note that reads "Letter from J. Previant, Mr H. Goldstein of Ft. Wayne". The back of the form has section...
Dates: 1909 October 18
- Subject: Application forms X