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Application of Edward Lipkin to JCRS, 1905 July 19

 Item
Identifier: B002.01.0097.0062.00001

Abstract

Application for admittance to JCRS filled out by hand for Edward Lipkin and dated July 19, 1905. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed Edward Lipkin. The back of the form has sections titled "Report of Medical Advisory Board," blank, and "Report of Executive Committee," blank. The middle section of the back is a form filled out by hand in ink. It reads, "No. 110, Case #67, Application of Edward Lipkin, July 19/05, Date of Admission Sept. 7, 1905, Died October 20, 1905."

Dates

  • 1905 July 19

Creator

Rights and Usage Statement

This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). http://rightsstatements.org/vocab/InC-EDU/1.0/

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 Upper righthand corner is missing. 30 x 22 centimeters

General

reformatted digital

Title supplied by archivist.

Inscription and Marks

Handwritten at the bottom of the application, "Admitted 9/7/05, Died 10/20/05."

Repository Details

Part of the Special Collections and Archives Repository

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