Skip to main content

Application of Harry Dorfman to JCRS, 1906 July 3

Identifier: B002.01.0097.0168.00002


Application for admittance to JCRS filled out by hand for Harry Dorfman and is dated Jul 3, 1906. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed Yiddish signature. 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. 255, Case #178, Application of Harry Dorfman, July 3/06, Date of Admission, August 8 1906, Date of Discharge (crossed out) Left, January 1 1907."


  • 1906 July 3


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 31 x 22 centimeters


reformatted digital

title supplied by archivist

Inscription and Marks

Handwritten in pen, at top of page: "255 (underlined)." Stamped in blue ink, at bottom left-hand corner: "Received Jul 3 1906, Accepted Aug 7 1906, Admitted Aug. 8/06, Discharged, Left, Died."

Repository Details

Part of the Special Collections and Archives Repository

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