Application of Dave Bailin to JCRS, 1906 January 2

Item

Identifier: B002.01.0097.0105.00005

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for Dave Bailin and dated Jan 2, 1906. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed D Bailin. 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 in ink. It reads, "No. 178, Case #98, Application of Dave Bailin, Jan 2/06, Date of Admission January 12 1906, Date of Discharge (crossed out) Died January 14, 1906." A handwritten note underneath reads: "Buried in Mount Nebo Cemetery Jan. 15/06, Section L., Lot. 29."

Dates

1906 January 2

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.