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Ike Schroetter's Application for Admittance to JCRS, between 1905 March 20-April 23

 Item
Identifier: B002.01.0097.0042.00001

Overview

Application for admittance to JCRS filled out by hand for Ike Schroetter and dated March 20, 1905. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed "Ike Schroetter." The back of the form has sections titled "Report of Medical Advisory Board" and "Report of Executive Committee" both blank. The middle section of the back is a form filled out by hand in ink. It reads, "No. 70, Case #37, Application of, Ike Schroetter, Mar. 20/05, Date of Admission April 15 1905, Date of Discharge [crossed out] Died April 23 1905."

Dates

  • between 1905 March 20-April 23

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: "Rece 3-20-05, Dis." Stamped in the top right corner of the front page: "Received 3-20-05, Accepted, Admitted 4-15-05, Discharged, Left, Died 4-23-05."

Repository Details

Part of the Special Collections and Archives Repository

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