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Robert Tatz's Third Application for Admittance to JCRS, 1909 March 9

 Item
Identifier: B002.01.0101.0027.00001

Overview

Application for admittance to JCRS filled out by hand in ink for Robert Tatz. Information on the form includes his age, place of birth, occupation, residence, residence, marital status, children's ages, previous hospital stays, membership to beneficial societies or lodges, nearest relatives, and signed in Yiddish by Robert Tatz. At the bottom of the page, under "Recommendation," are two names and addresses. The first reads "J. [illegible], 2729 W. Colfax st" and the second reads "M. Schoener, 1463 Grove St." The back of the form has section entitled "Report of the Medical Examiner," is left blank. The middle section of the back is a form filled out by hand in ink. It reads "Application No. 1047, Case No. 713, 3rd Application of Robert Tatz, Address 618 Vrain St., Received Mar 9 1909, Accepted Mar 13 1909, Admitted Mar 13 1909, Died Mar 24 1909." The bottom of the page reads "Admission and Dismission Committee" which is blank.

Dates

  • 1909 March 9

Creator

Language of Materials

Materials mostly in English except for a signature in Yiddish.

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.

Physical Characteristics and Technical Requirements

On the back of the form, in the middle section at the top "EMERGENCY" is stamped in blue ink.

General

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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