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Annie Cohen's Application for Admittance to JCRS, 1908 September 16

Identifier: B002.01.0100.0064.00001


Application for admittance in to the JCRS filled out in hand in ink for Annie Cohen. Information on the form includes her age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Annie Cohen. At the bottom of the page under "Recommendtion," it has been left blank. The back of the form has a section entiteld "Report of Medical Examiner" it has been left blank. The middle section of the back is a from filled out by hand in ink. It reads "Application no 903, Case No 615, Annie Cohen, Received Sept 16 1908, Accepted Sept 15 1908, Admitted Sept 16 1908, Died Dec 13 1908". Under "Remarks" there is a purple inked stamp that reads "EMERGENCY". The bottom of the page reads "Admission and Dismission Committee" which is left blank.


  • 1908 September 16


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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.


Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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