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Minnie Greenberg's Application for Admittance to JCRS, 1909 May 3

 Item
Identifier: B002.01.0101.0051.00001

Overview

Application for admittance to JCRS filled out by hand in ink for Minnie Greenberg. Information on the form includes her age, place of birth, occupation, residence, marital status, previous hospital stays, nearest relatives, and signed by Minnie Greenberg. At the bottom of the page, under "Recommendation," are two names and addresses. The first reads "Louis Schapiro, Address 2709 W Colfax Ave." The second reads "E. Freidman, Address 2760 [illegible] Ave." The back of the form has section entitled "Report of Medical Examiner," which states the exam took place on May 3, 1909 and finds the patient to be suffering from second stage tuberculosis. Remarks include "well advanced, both lungs - left lung especially. Fever 100.2 and pulse 130 at 10AM. Much [illegible]" and is signed by R.C. Charles, MD. The middle section of the back is a form filled out by hand in ink. It reads "Application No. 1091, Case No. 758, Application of Minnie Greenberg, Address 1526 Dale court, Received May 3 1909, Accepted May 21 1909, Admitted May 21 1909, Died May 25 1909." The bottom of the page reads "Admission and Dismission Committee" which is blank.

Dates

  • 1909 May 3

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.

Physical Characteristics and Technical Requirements

At the top of the middle section on the back of the form "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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