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Harry B Bernstein's Application for Admittance to JCRS, 1909 November 22

 Item
Identifier: B002.01.0102.0025.00001

Overview

Application for admission to JCRS filled out by hand in ink for Harry B. Bernstein. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, and nearest relatives. Form is signed "Harry B. Bernstein." Nearest relative is listed as "Parents Marie + Abr. Bernstein - 1800 Wylie Ave - Pitts Pa." In the Recommendation section at the bottom of the page there is a note that reads "Letter from Mrs. H.B. Ferguson + B. Horvitz" The section "Report of the Medical Examiner" on the back side of the form states examination took place on October 18, 1909, found that Mr. Bernstein suffered from stage 1 tuberculosis and is signed "Hillkowitz". The middle section of the back of the form reads "Application No. 1277. Case No. 879. Application of Harry B Bernstein. Address general delivery Received Nov 22 1909. Admitted Dec 1 1909. Left [illegable month] 15 1910." The "Admission and Dismission Committee" section of the back of the form is left blank.

Dates

  • 1909 November 22

Creator

Conditions Governing Use

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Extent

1 items

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.

General

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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