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Application of Morris Perl to JCRS, 1905 December 21

 Item
Identifier: B002.01.0097.0100.00001

Abstract

Application for admittance to JCRS filled out by hand for Morris Perl and dated December 21, 1905. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed by Morris Perl. The back of the form has sections titled "Report of Medical Advisory Board," and "Report of Executive Committee," blank. The middle section of the back is a form filled out by hand. It reads, "Application No. 172, Case No. 100, Application of Morris Pearl, Dec 21/05. Date of admission January 13, 1906. Date of Death, May 19, 1906." Handwritten below, "Buried in Mount Nebo Cemetery May 19/06 Sec. 26, Lot O."

Dates

  • 1905 December 21

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 top, "172," "Take him in." Stamped in blue ink and filled out by hand at the upper right, "Received: Dec 21 1905; Accepted Jan. 13 -06; Admitted: Jan 13 -06; Died: May 19/06"

Repository Details

Part of the Special Collections and Archives Repository

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