Rose Zeretzky's Application for Admittance to JCRS, 1910 July 24-1911 September 26

Item

Identifier: B002.01.0103.0019.00001

Staff Only

Overview

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

Extent

1 items (application)

Additional Description

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.