Hyman Gold's Application for Admittance to JCRS, 1908 July 29
Application for admittance to JCRS filled out by hand in ink for Hyman Gold. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Hyman Gold. Under "Recommendation" are two names and addresses, M. Feldman, 2862 Lar [Larimer] Street and Louis Shapiro, 2709 W. Colfax. The back of the form has section entitled "Report of Medical Examiner," which is dated July 29, 1908 and states that the applicant is suffering from the second stage of pulmonary tuberculosis. Remarks reads " [illegible] also asthma. [illegible] at times" and is signed Emanuel Friedman. The middle section of the back is a form filled out by hand in ink. It reads "Application No. 856 Case No. 657, Application of, Hyman Gold, 1315 Irving St., Received July 29, 1908, Admitted Nov. 16, 1908, Left Mar. 4, 1908." The bottom of the page reads "Admission and Dismission Commitee" which is blank.
- 1908 July 29
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
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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
Under "Remarks" is a note in pencil which reads "[Wrote] to S.F. Disraelly 7/31-, Disraelly to report 9/14/08."
Title supplied by archivist.