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Application of Harry Miller to JCRS, 1906 July 5

 Item
Identifier: B002.01.0097.0172.00002

Abstract

Application for admittance to JCRS filled out by hand for Harry Miller 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 Harry Miller. 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. 259, Case #182, Application of Harry Miller, July 5/06, Date of Admission, August 26 1906, Date of Discharge, Oct 21 1906, Died Nov. 17/06. Buried at Rose hill Cemetery, Block 84 Lot 6. (handwritten)."

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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/

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1 Items (application)

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