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Louis Wolf's Application for Admittance to JCRS, 1909 March 6

 Item
Identifier: B002.01.0101.0030.00001

Overview

Application for admittance to JCRS filled out by hand in ink for Louis Wolf. Information on the form includes his age, place of birth, occupation, residence, marital status, previous stays in a Sanatorium or Hospital, nearest relatives, and is signed by Louis Wolf. At the bottom of the page, under "Recommendation," are two names and addresses. The first reads "M. Feldman, 1527 Dale Court." The second reads "S. Z. [Illegible], 2793 W. Colfax Ave." The back of the form has a section entitled "Report of the Medical Examiner," which states that the examination took place March 8, 1909 and states that Louis Wolf suffers from stage two tuberculosis. Also remarks that he had a temperature of 99 and 3/5 at 3 pm. Report is signed by Emanuel Friedman. The middle section of the back is a form filled out by hand in ink. It reads "Application No. 1049, Case No. 730, Application of Louis Wolf, Address 2709 W Colfax Ave, Received Mar 6 1909, Accepted April 20 1909, Admitted April 21 1909, Discharged May 9 1910." The bottom of the page reads "Admission and Dismission Committee" which is blank.

Dates

  • 1909 March 6

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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