Application of Herman Spiegel to JCRS, 1905 September 25

Item

Identifier: B002.01.0097.0076.00002

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for Herman Spiegel and dated Sept. 25/05. 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. 137, Case #73, Application of Herman Spiegel. Date of Admission, Sept 25/05, Date of Admission September 28, 1905. Left Nov. 21, 1905.

Dates

1905 September 25

Creator

Jewish Consumptives' Relief Society (U.S.) (Recipient, Organization)

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)

Additional Description

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

General

reformatted digital

Title supplied by archivist.

Inscription and Marks

Handwritten at the top right, "Rec'd 9-25-05." Handwritten to the left of the signature line, "See letter from Schoen." Filled out in handwriting, a small form stamped in blue ink, "Received: Sept. 25, 05; Accepted: " 28, 02; Left: 11-21-05."