Max Zenker's Application for Admittance to JCRS, 1906 March 28

Item

Identifier: B002.01.0097.0128.00004

Staff Only

Abstract

Application for admittance to JCRS filled out by hand in ink for Max Zenker. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Max Zenker. Under "Recommendation" are two names which read Herman Steiner and Morris E. Brenner. The back of the form has section entitled "Report of Medical Advisory Board," which is blank. The middle section of the back is a form filled out by hand in ink. It reads "No. 208, Application of, Max Zenker, Mar 29/06, Date of Admission May 6, 1906, Date of Discharge July 19, 1906."

Dates

1906 March 28

Creator

Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)

Conditions Governing Use

This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). http://rightsstatements.org/vocab/InC-EDU/1.0/

Extent

1 Items (application)

Additional Description

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

Written in ink on the top of the front page is a note which reads "208." Towards the bottom middle of the page and to the left of "Signature of Applicant" is a stamp, some of which is filled out by hand in ink, which reads "RECEIVED MAR 29 1906, ACCEPT May 4/06, ADMITTED MAY 6 1906, DISCHARGED July 19/06, LEFT, DIED." On the top middle of the back page above "Application Of" is a note written in red ink which reads "Case #134." Below "Date of Discharge" is a note written in ink which reads "died Sept. 9, 1908 at Sanatorium. (see app 851).