Application of Max Brown to JCRS, 1906 April 12

Item

Identifier: B002.01.0097.0132.00007

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for Max Brown and is dated April 12, 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. 212, Case #134 (crossed out) 133, Application of, Max Brown, Apr 12/06, Date of Admission, May 7 1906, Date of Discharge (crossed out) leaving, June 25 1906."

Dates

1906 April 12

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.

Physical Characteristics and Technical Requirements

Poor Bottom crease is cracking. 31 x 22 centimeters

General

reformatted digital

title supplied by archivist

Inscription and Marks

Handwritten in blue ink, at the bottom left-hand corner: "Received Apr 12 1906, Accepted May 4/06, Admitted May 7/06, Discharged, Left June 25/06, Died."