Application of Mary Cohen to JCRS, 1905 October 11

Item

Identifier: B002.01.0097.0078.00001

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for Mary Cohen and dated Oct. 11/05. Information on the form includes her age, birth place, occupation, residence, marital status, nearest relatives, and signed by Mary Cohen. 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. 141, Case #95, Application of Mary Cohen. Date of Admission, Oct. 11/05, Date of Admission December 23, 1905. Left October 15, 1906.

Dates

1905 October 11

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 upper righthand corner, "Received Oct 11, 1905." A form stamped in blue ink across the upper right of the document is filled out as followed, "Received: 10/11/05, Accepted: December 18, 1905, Admitted: December 23, 1905, Left: October 15, 1906."