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Alexander Reveles' First Application for Admittance to JCRS, 1907 June

 Item
Identifier: B002.01.0100.0074.00002

Overview

First applicaiton for admittance to JCRS 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 under "Recommendation" are two names and addresses. First one reads "S.F. Disraelly, 1652 Larimer St.", second one the name is illegible but address is "1653 Larimer St.". The back of the form has a section entitled "Report of Medical Examiner," which has been left blank. The middle section of the back is a form filled out by hand in ink. It reads "Application No. 511, Case No. 339, Alexander Reveles, JCRS, Edgewater, Colo., Received June 18 1907, Admitted June 15 1907, Left August 4 1907." The bottom of the page reads "Admission and Dismission Committee" which is blank.

Dates

  • 1907 June

Creator

Language of Materials

From the Collection: The records are primarily in English, but some materials are in other languages, including Hebrew, Yiddish, German, and Russian.

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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