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Application of Harry Sukernick to JCRS, 1907 June 7

 Item
Identifier: B002.01.0098.0126.00001

Overview

Application for admittance to JCRS filled out by hand for Harry Sukernick and dated June 7, 1907. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed H. Sukernick. 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. 499, Case No. 372, Application of, H. Sukernick, Address 1518 Boulevard, Denver, Colo., Received June 7 1907, Accepted June 13 1907, Rejected, Admitted August 25 1907, Readmitted, Discharged March 31 1908, Left, Died, Remarks: see remarks on 2nd application #224 as follows: 'application to be dropped. gets money from home, parents well fixed. he is the only son' add (circled) accept 6/13/07 died sept 1908 at Havenhill, Mass."

Dates

  • 1907 June 7

Creator

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 31 x 22 centimeters

General

Title supplied by archivist

Inscription and Marks

Handwritten in black and red ink, on back page, at top of page: "third (underlined three times)."

Repository Details

Part of the Special Collections and Archives Repository

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