Lena Greenberg's Application for Admission to JCRS, 1909 April 27
Application for admittance to JCRS filled out by hand in ink for Lena Greenberg. Information on the form includes her age, place of birth, occupation, residence, marital status, children's ages, membership to beneficial societies or lodges, nearest relatives, and signed "Lena Greenber" by her husband. At the bottom of the page, under "Recommendation" are two names and addresses. The first reads "Louis Schapiro, 2709 W. Colfax Ave." The second reads "Robin Halpern, 1516 Boulevard F." The back of the form has section entitled "Report of Medical Examiner," which states the exam took place April 27, 1909" and reports that the patient suffers from stage three tuberculosis. The remarks of the medical examiner are largely illegible and signed by Emanual Friedman. The middle section of the back is a form filled out by hand in ink. It reads "Application No. 1088, Case No. 766, Application of Lena Greenberg, Address 1512 Elliot St., City, Received Apr 27 1909, Accepted May 25 1909, Admitted May 27 1909, Died July 7 1909." The bottom of the page reads "Admission and Dismission Committee" which is blank.
- 1909 April 27
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
Language of Materials
From the File: Materials in English and Yiddish.
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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
On the front of the application, where Lena Greenberg's signature, is a note that reads "By husband" indicating that her husband had signed for her. On the back of the form, at the top of the middle section "Emergency" is stamped in blue ink.
Title supplied by archivist.