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Application from J. Schwartz to JCRS, 1908 December 16

 Item
Identifier: B002.01.0100.0111.00001

Overview

Application for admittance to JCRS in Denver, Colorado filled out by hand for Joe Schwartz and dated "Decem. 16 1908" [sic]. Information on the form includes the patient's age, birth place, citizenship, occupation, current residence and residence information, health information, marital status, number of children and their ages, nearest relatives or friends, and the application is signed by Joe Schwartz. The bottom of the form is labled "RECOMMENDATION...Signed at Denver this 16 day of Decem. 1908," and includes two character references with names and addresses [sic]. The back of the form has sections titled "Report of Medical Examiner," blank, and "Admission and Dismission Committee," blank. The middle section of the back is a form filled out by hand. It reads, "Application No. 985, Case No. 673, APPLICATION OF Joe Schwartz Address 2628 W. 14th Ave. Received Dec. 16 1908 Accepted Dec 21 1908 Admitted Dec 21 1908 Died Feb. 12 1909" [sic].

Dates

  • 1908 December 16

Creator

Inscriptions and marks

Stamped on the top of the middle section of the back of the application form in bluk ink reads, "EMERGENCY" [sic].

Conditions Governing Use

Copyright restrictions may apply. User is responsible for all copyright compliance.

Extent

1 items (application)

Scope and Contents

From the Series: This series of patient records includes medical reports and histories, statistical data of patients, x-rays, and death certificates. The patient files include applications, correspondence and some may also contain photographs and personal items.

Inscriptions and marks

Stamped on the top of the middle section of the back of the application form in bluk ink reads, "EMERGENCY" [sic].

General

Title supplied by archivist.

Creator

Repository Details

Part of the Special Collections and Archives Repository

Contact:
2150 East Evans Avenue
Denver CO 80208
(303) 871-3428