Skip to main content

Application of Gussie Glick to JCRS, 1905 November 10

Identifier: B002.01.0097.0075.00001


Application for admittance to JCRS filled out by hand for Gussie Glick and dated November 10, 1905. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed by Gussie Glick. 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. It reads, "No. 134, Case #78, Application of Gussie Glick. Date of Admission, November 10, 1905, Date of Leaving May 28, 1906. Handwritten at the bottom, "Died Nov 20, 1906, County Hospital.


  • 1905 November 10


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).


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 31 x 22 centimeters


reformatted digital

Title supplied by archivist.

Inscription and Marks

Handwritten at the top right, "Rec'd 9-14-05." Handwritten at the top center, "134." Handwritten into a form stampled in blue ink at the top right, "Received: September 14/05, Accepted: Nov. 1/05, Admitted Nov. 10, 1905, Left May 28, 06."

Repository Details

Part of the Special Collections and Archives Repository

2150 East Evans Avenue
Denver CO 80208
(303) 871-3428