Rose Barkar's Application for Admittance to JCRS, 1906 June 27

Item

Identifier: B002.01.0097.0166.00001

Staff Only

Abstract

Application of admittance to JCRS filled out by hand in ink for Rose Barkan. Information on form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed by Rose Barkan. At the bottom of the page there is a stamp in blue ink that states "Received Jun 27 1906, Accepted Jun 28 1906, Admitted Jun 30 1906". The back of the form has a section entitled "Report of Medical Advisory Board, and Report of Executive Committe" that is not filled out. There is pink ink that has been smudged at the top right corner. The middle section of the back is a form filled out by hand ink. It reads "no 2150 Case # 163 (164 in red ink was crossed out), Application of Rose Barkan, June 27/06, Date of Admission Jun 30 1906 (blue ink stamp), Left November 10 1906 (Date of Discharge is crossed out)".

Dates

1906 June 27

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.