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Max Glick's Second Application for Admittance to JCRS, 1909 October 11

 Item
Identifier: B002.01.0102.0002.00001

Overview

Second application for addmittance to JCRS in Denver, Colorado filled out in black ink for Max Glick amd dated October 11, 1909. Information on the form includes his sex, age, birth place, occupation, residence, marital status, children's ages, societies or lodges belonged to, nearest relatives and is signed by Max Glick. In the "Beneficial Societies or Lodges" section "Independent Order of Odd Fellows" and "Independent Order of Bnai Brith" are listed. Nearest relatives are listed as "Harry Glick, Munhall, PA, Brother. Joseph [illegible], 335 8th Ave, Homestead, Brother-in-law." and In Denver "Wife, Annie Glick, 3235 Conejos Pl." The "Recommendation" section at the bottom of the form is left blank. The back of the application form reads "Application No. 1242, Case No. 845, 2nd Application of Max Glick, Received Oct 7th 1909, Admitted Oct 7 1909, Discharged Nov 15 1909." The "Report of Medical Examiner" and "Admission and Dismission Committee" sections are left blank.

Dates

  • 1909 October 11

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 side of the application form "EMERGENCY" is stamped in red over the middle section.

General

Title supplied by archivist.

Creator

Repository Details

Part of the Special Collections and Archives Repository

Contact:
2150 East Evans Avenue
Denver CO 80208
(303) 871-3428