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Application of Samuel Pomerantz to JCRS, 1905 August 1

 Item
Identifier: B002.01.0097.0065.00004

Abstract

Application for admittance to JCRS filled out by hand for Samuel Pomerantz and dated August 1, 1905. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed Samuel Pomerantz. 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. 113, 72, Application of Samuel Pomerantz, August 1/05, Date of Admission September 28, 1905, Date of Discharge Feb 1, 1906.

Dates

  • 1905 August 1

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 30 x 22 centimeters

General

reformatted digital

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

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