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Alexander Horwitz's Application for Admittance to JCRS, between 1904 August 22-October 5

 Item
Identifier: B002.01.0097.0012.00001

Overview

Application for admittance to JCRS filled out by hand for Alexander Horwitz and dated August 22, 1904. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed by Alexander Horwitz. The back of the form has sections titled "Report of Medical Advisory Board," blank, and "Report of Executive Committee," both blank. The middle section of the back is a form filled out by hand in ink. It reads, "16, No. 13, 16 [both crossed out], Case #8, Application of, Alexander Horwitz, Appl. Aug 23/04, Date of Admission Sep 23 1904, Date of Discharge Oct 5 1904."

Dates

  • between 1904 August 22-October 5

Creator

Rights and Usage Statement

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

Fair 30 x 22 centimeter

General

reformatted digital
Title supplied by archivist.

Inscription and Marks

Handwritten in the top right corner of the front page: "Received, Aug 23, 1904, dis."

Repository Details

Part of the Special Collections and Archives Repository

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