Adolph Fiertag's Second Application for Admittance to JCRS, 1910 July 5-1910 August 9
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.
- 1910 July 5-1910 August 9
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
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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
At the top of the middle form on the back of the application "Emergency" is written in black ink.
Title supplied by archivist.