Rose Zeretzky's Application for Admittance to JCRS, 1910 July 24-1911 September 26
Item
Identifier: B002.01.0103.0019.00001
Abstract
Application for admittance to JCRS filled out by hand in ink for Rose Zeretzky. Information on the form includes her age, birth place, residence, occupation, marital status, children's ages, and nearest relatives, and is signed by Mrs. R. Zeretzky. At the bottom of the page is a section entitled "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.1525, Case No.1035, Application of Mrs. Rose Zeretzky, Address Denver Colo., Received 7-24-10, Admitted July 24, 10, Died Sept 26/1911." The bottom of the page reads "Admission and Dismission Committee" which is blank.
Dates
- 1910 July 24-1911 September 26
Creator
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
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 section on the back of the form "EMERGENCY" is stamped in red ink.
General
Title supplied by archivist.
Creator
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
Repository Details
Part of the Special Collections and Archives Repository