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Application of A.D. Kaufman to JCRS, 1905 November 1

 Item
Identifier: B002.01.0097.0094.00001

Abstract

Application for admittance to JCRS filled out by hand for A.D. Kaufman and dated November 1, 1905. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed by A.D. Kaufman. 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. 165, Case #75, Application of A.D. Kaufman. Date of Admission November 1, 1905. left Dec. 5, 1905. Handwritten below, "Emergency."

Dates

  • 1905 November 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.

Inscription and Marks

Handwritten at the upper left, "Emergency." Stamped in blue ink and filled out by hand at the upper right, "Admitted: Nov 1 1905; Left: Dec. 5 1905."

Repository Details

Part of the Special Collections and Archives Repository

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