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Louis Bama's Application for Admittance to JCRS, 1910 August 10-1911 May 1

 Item
Identifier: B002.01.0103.0034.00001

Overview

JCRS application filled out by hand in ink for Louis Bama. Information on the form includes his age, birth place, occupation, marital status, membership to beneficial societies or lodges, nearest relatives, and is signed by Louis Bama. At the bottom of the page is a section titled "Recommendation," which is left blank. The back of a form, "Report of Medical Examiner" informs that the examination took place on August 10, 1910 and reports that the patient suffers from incipient stage of tuberculosis and 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. 1544, Case No. 1087, Application of Louis Bama, Address 1381 Osceola St., Received August 8/10, Admitted Sept 21/10, Discharged May 1/1911." The bottom of the page reads "Admission and Dismission Committee" which is blank.

Dates

  • 1910 August 10-1911 May 1

Creator

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.

General

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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