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Alexander Reveles' Second Application for Admittance to JCRS, 1908 September 25

 Item
Identifier: B002.01.0100.0074.00001

Overview

Second application for Admittance to JCRS is filled out by hand in ink for Alexander Reveles. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Alexander Reveles. At the bottom of the page, undder "Recommendation" are two names and addresses. First one reads "Louis Schapiro, 2709 W Colfax Ave", and the second name reads "N. Wiruer, 2626 W Colfax Ave." The back of the form has a section entited "Report of Medical Examiner," which states that the examination was made the same day as filling out the application and signed by C.D. Elbalbach. The middle section of the back is a form filled out by hand in ink. It reads "App. No. 920, Case No. 998, Alexander Reveles, Receieved Sept 30 1908, Accepted Sept 30 1908, Admitted July 13 1909, Discharged Aug 9 1909." Underneath handwritten in pencil reads "Oct 1/08 wrote Mrs. Louber to investigate. Not to be considered at all, Disraelly Nov 23, 1908." The bottom of the page reads "Admission and Dismission Committee" which is blank.

Dates

  • 1908 September 25

Creator

Conditions Governing Use

Copyright restrictions may apply. User is responsible for all copyright compliance.

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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