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Application for Harry Johnson to JCRS, 1906 December 15

 Item
Identifier: B002.01.0098.0038.00002

Overview

Application for admittance filled out by hand for Harry Johnson and dated December 15, 1906. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Harry Johnson. The back of the form has sections titled "Report of Medical Examiner," which is dated December 17, 1906. It notes that Harry Johnson is in the first stage of pulmonary tuberculosis, and contains further details of his physical condition. The middle section of the back has "Application No. 381. Application of Harry Johnson, Received December 15, 1906, Accepted January 7, 1907, Admitted January 7, 1907, Discharged June 7, 1907.

Dates

  • 1906 December 15

Creator

Digital Repository

Application for Harry Johnson to JCRS

Rights and Usage Statement

Copyright restrictions may apply. User is responsible for all copyright compliance.

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 30 x 22 centimeters

General

reformatted digital
Title supplied by archivist.

Inscription and Marks

Handwritten and underlined at the top right, "Jew."

Repository Details

Part of the Special Collections and Archives Repository

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