Benj. Saritsky's Application for Admission to JCRS, 1910 August 10-1911 May 8
JCRS Application filled out by hand in ink for Benj. Saritsky. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and includes a signature in Yiddish. At the bottom of the page is a section entitled "Recommendation," which is left blank except for a note that reads "Letter from H. Masliansky." The back of the form has a section called "Report of Medical Examiner" which states that the examination took place on August 11, 1910 and found Saritsky to be suffering from incipient tuberculosis. The report of medical examiner 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. 1543, Case No 1069. Application of 'Benj. Zaritzky,' [archivist infers this is Benj. Saritsky] Address 1342 Hooker Street, Received August 10 1910, Admitted Sept 05/10, Discharged May 8/11." The bottom of the page reads "Admission and Dismission Committee" which is blank.
- 1910 August 10-1911 May 8
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
Language of Materials
Materials mostly in English except for a signature in Yiddish.
Conditions Governing Use
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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
On the back of the form, at the top of the middle section is a handwritten note that reads "Bklyn."
Title supplied by archivist.