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Application of Max Brown to JCRS, 1906 April 14

 Item
Identifier: B002.01.0097.0129.00002

Abstract

Application for admittance to JCRS filled out by hand for Max Brown and is dated March 14, 1906. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed Max Brown. 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. 209, Case 114, Application of, Max Brown, March 14/06, Date of Admission, March 14 1906, Date of Discharge, March 29 1906, Emergency Case (handwritten)."

Dates

  • 1906 April 14

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 31 x 22 centimeters

General

reformatted digital

title supplied by archivist

Inscription and Marks

Stamped in blue ink, at bottome left-hand corner: "Received, Accepted, Admitted March 14/06, Discharged " 29/06, Left, Died."

Repository Details

Part of the Special Collections and Archives Repository

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