Adolph Fiertag's Application for Admittance to JCRS, 1910 May 10-1910 July 4
Application for admittance to JCRS filled out by hand in ink for Adolph Fiertag. Information on the form includes his age, birth place, occupation, residence, marital status, previous hospital stays, membership to beneficial societies and lodges, nearest relatives, and signed by Adolph Fiertag. At the bottom of the page is a section named "Recommendation," which is left blank. The back of the form has section entitled "Report of Medical Examiner," which is left blank. The middle section of the back is a form filled out by hand in ink. It reads "Application No.1458, Case No.978, Application of Adolph Fiertag, Address Sanatorium JCRS, Received May 10 1910, Admitted May 10 1910, Discharged July 4 1909." The bottom of the page reads "Admission and Dimission Committee" which is blank.
- 1910 May 10-1910 July 4
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
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1 items (letter)
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 form on the back of the application, "emergency" is stamped in red ink.
Title supplied by archivist.