Abraham Burger's Application for Admittance to JCRS, 1909 March 27
Application for admittance to JCRS filled out by hand in ink for Abraham Burger. Information on the form includes his age, place of birth, occupation, residence, marital status, previous hospital stays, nearest relatives and is signed by Abraham Burger. At the bottom of the page, under "Recommendation," are two names and addresses. The first reads "Name Sam Lang, Address 918 15th St." The second reads "L.M. Weiner, Address 1284 Corona St." The back of the form has section entitled "Report of Medical Examiner," which states that the exam took place March 31, 1909 and states the patient suffers from stage two tuberculosis. The medical examiner wrote remarks but these are mostly illegible, except for a note that reads "T101 at 3pm" and is signed by Emanuel Friedman. The middle section of the back is a form filled out by hand in ink. It reads "Application No. 1069, Case No. 757, Application of Abraham Burger, Address 2947 California St, Received Mar 27 1909, Accepted May 15 1909, Admitted May 18 1909, Left June 30 1909, Remarks: take in next." The bottom of the page reads "Admission and Dismission Committee" which is blank.
- 1909 March 27
- 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.
Physical Characteristics and Technical Requirements
At the middle section of the back of the form "Emergency" is stamped in blue ink at the top.
Title supplied by archivist.