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Adolph Berman's Second Application for Admittance to JCRS, 1905 November 15

 Item
Identifier: B002.01.0100.0058.00019

Overview

Application for admittance to JCRS filled out by hand in ink for Adolph Berman. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed by Adolph Berman. At the page under "Recommendation" are signatures that are illegible. The back of the form has a section entitled "Report of medical Advisory Board" which has been left blank. The middle section of the back is a form filled out by hand in ink. It reads "No. 155 - Case 82, Adolph Berman, November 1/05, Date of Admission November 24 1905, Left March 18 1906".

Dates

  • 1905 November 15

Creator

Conditions Governing Use

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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.

General

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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