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Application from Beckie Moses to JCRS, 1905 December 21

Identifier: B002.01.0097.0101.00003


Application for admittance to JCRS filled out by hand for Beckie Moses and dated December 21, 1905. Information on the form includes her age, birth place, occupation, residence, marital status, nearest relatives, and signed in Russian. 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. 173, Case No. 102, Application of Beckie Moses, Dec 21/05. Date of admission January 17, 1906. Date of Death, May 9, 1906." Handwritten below, "Buried in Mount Nebo Cemetery May 10/06 Sec. L, Lot 50."


  • 1905 December 21


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).


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 28 x 22 centimeters


reformatted digital

Title supplied by archivist.

Repository Details

Part of the Special Collections and Archives Repository

2150 East Evans Avenue
Denver CO 80208
(303) 871-3428