Application of Bessie Holstein to JCRS, 1905 December 21

Item

Identifier: B002.01.0097.0095.00006

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for Bessie Kaufman and dated December 21, 1905. Information on the form includes her age, birth place, occupation, residence, marital status, nearest relatives, and signed by Mrs. Holstine. 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. 166, Case #92, Application of Bessie Holstein. Date of Admission December 21, 1905. Died November 23, 1906. Handwritten below, "Buried in Mount Nebo Cemetery, 11/25/06 Section L, Lot 54."

Dates

1905 December 21

Creator

Jewish Consumptives' Relief Society (U.S.) (Producer, 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 28 x 22 centimeters

General

reformatted digital

Title supplied by archivist.

Inscription and Marks

Stamped in blue ink and filled out by stamp and hand in the upper right-hand corner, "Received: December 11 1905; Accepted: Dec 13 1905; Admitted: Dec 21 1905; Died: Nov 23 1906."