JCRS Patient #1526. Boston, MA.
Found in 1 Collection or Record:
Abstract Application for admission to JCRS filled out by hand in ink for Sam Cohen. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and membership to beneficial societies or lodges. The application is signed in Yiddish. At the bottom of the page, the section "Recommendation," is left blank. The back of the form has section entitled "Report of Medical Examiner," which is left blank. The middle section of the back is a form...
Dates: 1910 July 28-1910 September 15