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Fannie Berman's Application for Admittance to JCRS, 1908 December 10

 Item
Identifier: B002.01.0100.0108.00001

Overview

Application for admittance to JCRS filled out by hand in ink for Fannie Berman. Information on the form includes her age, birth place, citizenship, occupation, residence information, medical information, marital status, nearest relatives [Louis and Jacob Berman], and signed by Fanny Berman [Fannie]. The bottom of the form there is a section titled "RECOMMENDATION," which has been left blank. The back of the form has section entitled "Report of Medical Examiner," which reads "Stage 2+...Illegible...Temp 101.6 Pulse 170...Illegible... Signed C. D. Spivak" [sic]. The middle section of the back reads, "Application No.980 [979 crossed out], Case No. 676, APPLICATION OF Fannie Berman, Address 1471 Knox Court, Received Dec. 10, 1908, Accepted Jan. 4, 1909, Admitted Jan. 4, 1909, Died Jan. 17, 1909" [sic]. The bottom of the page reads "Admission and Dismission Commitee," which is blank [sic].

Dates

  • 1908 December 10

Creator

Inscriptions and marks

Stamped in purple ink on the top of the middle section of the back 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 in purple ink on the top of the middle section of the back 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