Annie Levine's Application for Admittance to JCRS, 1908 September 17
Application for Admittance to JCRS filled out by hand in ink for Annie Levine. Information on the form includes her age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed in Yiddish by Annie Levine. At the bottom of the page, under "Recommendation," it reads "see letter of evelenko attached to app of husband #908". The back of the form has a section entitled "Report of Medical Examiner" which states that the examination was made one day prior to filled out the application and signed by Dr. Hillkowitz. The middle section of the back is a form filled out by hand in ink. It reads "No. 907, Case No 675, Annie Levine, 2929 W 16th ave. Denver, Received Sept 17 1908, Accepted Sept 23 1908, Admitted Sept 23 1908, Discharge July 1 1909". The bottom of the page reads "Admission and Dismission Committee" which is blank.
- 1908 September 17
- 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.
Title supplied by archivist.