Application for Charles Rose to JCRS, 1907 May 23
Application for admittance to JCRS filled out by hand for Charles Rose and dated May 23, 1907. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and not signed. 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. 488, Case No., Application of, Charles Rose, Address, Received, Accepted, Rejected, Admitted May 23 1907, Readmitted, Discharged, Left, Died may 24 1907, Remarks emergency."
- 1907 May 23
- Jewish Consumptives' Relief Society (U.S.) (Producer, Organization)
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
Inscription and Marks
Stamped in blue ink, on back side of page, at top of page: "emergency."