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Jacob Silverstein's Application for Admittance to JCRS, 1910 August 3-1910 December 21

 Item
Identifier: B002.01.0103.0025.00001

Overview

JCRS Application filled out by hand in ink for Jacob Silverstein. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Jacob Silverstein. At the bottom of the page is a section entitled "Recommendation," which is left blank. The back of the form has a section called "Report of Medical Examiner" which states that the examination took place on August 8th, 1910 and found Silverstein to be an incipient case of tuberculosis. Report is signed by "Dr. M. Krohn." The middle section of the back is a form filled out by hand in ink. It reads "Application No. 1534, Case No 1073. Jacob Silverstein, Address 1471 Knox Court Denver, Colo, Received Aug 3 1910, Admitted Sept 17/10, Left December 21/10." The bottom of the page reads "Admission and Dismission Committee" which is blank.

Dates

  • 1910 August 3-1910 December 21

Creator

Conditions Governing Use

Copyright restrictions may apply. User is responsible for all copyright restrictions.

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.

General

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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