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Application of Julius S. Myers to JCRS, 1906 July 5

 Item
Identifier: B002.01.0097.0170.00001

Abstract

Application for admittance to JCRS filled out by hand for Julius S. Myers and is dated Jul 5, 1906. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed Julius S. Myers. 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. 257, Case #199, Application of Julius S. Myers, July 5/06, Date of Admission, September 25 1906, Date of Discharge, January 23 1908, 15/Jan 1908 extend 1/23/08 (handwritten)."

Dates

  • 1906 July 5

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

Handwritten in pen, at top of page: "257." Stamped in blue ink, at bottom left-hand corner: "Received Jul 5 1906, Accepted Sep. 22 1906, Admitted Sep. 25, 1906, Discharged, Left, Died." Stamped in blue ink, overlapping the first stamp, at bottom left-hand corner: "Goods Rec'd, Price Checked, Approved, Adutied by, Voucher No., Bill."

Repository Details

Part of the Special Collections and Archives Repository

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