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Application of Sam Goldberg to JCRS, 1907 May 20

Identifier: B002.01.0098.0116.00001


Application for admittance to JCRS filled out by hand for Sam Goldberg and dated May 20, 1907. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed Sam Goldberg. The back of the form has sections titled "Report of Medical Examiner" and "Admission and Dismission Committee," are blank. The middle section of the back is a form filled out by hand. It reads, "Application No. 482, Case No., Application of, Sam Goldberg, Address 1819 Grave St., Denver, Colo., Received May 20 1907, Accepted June 13 1907, Rejected, Admitted August 18 1907, Readmitted, Discharged, Left October 25 1907, Died, Remarks accepted 6/12/07, write to him at once aug. 15/07."


  • 1907 May 20


Rights and Usage Statement

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


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


Title supplied by archivist

Repository Details

Part of the Special Collections and Archives Repository

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