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Application of Susman Cholit to JCRS, 1906 February 21

 Item
Identifier: B002.01.0097.0117.00003

Abstract

Application for admittance to JCRS filled out by hand for Susman Cholit and is dated Feb 21, 1906. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed Susman Cholit.The back of the form has sections titled "Report of Medical Advisory Board" and "Report of Executive Committee," both are blank. The middle section of the back is a form filled out by hand. It reads, "No. 193, Case #113, Application of,Susman Cholit Feb 21/06, Date of Admission March 9, 1906, Date of Discharge (crossed out) Leaving August 2, 1906."

Dates

  • 1906 February 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

From the File: 0 Items : file folder

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 31 x 21

General

reformatted digital

title supplied by archivist

Inscription and Marks

Stamped in blue ink at top right-hand corner: "Received Feb. 21st 1906, Accepted march 3, 1906, Admitted March 3, 1906, Discharged, Left August 2/06, Died." Handwritten in top righthand corner: "Feb 21. 1906" Handwritten at top of application: "193."

Repository Details

Part of the Special Collections and Archives Repository

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