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Adolph Fiertag's Second Application for Admittance to JCRS, 1910 July 5-1910 August 9

 Item
Identifier: B002.01.0103.0005.00002

Overview

Second 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, and nearest relatives, and is unsigned. 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.1503, Case No.1019, Application of Adolph Fiertag, Received July 5 1910, Admitted July 5 1910, Died August 9 1910." The bottom of the page reads "Admission and Dimission Committee" which is blank.

Dates

  • 1910 July 5-1910 August 9

Creator

Language of Materials

From the Collection: The records are primarily in English, but some materials are in other languages, including Hebrew, Yiddish, German, and Russian.

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 form on the back of the application "Emergency" is written in black ink.

General

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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