Subject Source: Art & Architecture ThesaurusScope Note: Forms used by persons requesting assistance, authorization, employment, admission, or other action.
Found in 2 Collections and/or Records:
Overview Application form of David Gordon for admission as a patient to the Jewish Consumptives' Relief Society. He was age 43 at the time of the application. He was born in Romania and immigrated to the United States in 1904. He lived in Port Chester, New York when he contracted tuberculosis. He had been sick for one year upon his arrival to Denver, Colorado. He was married and had four children. His occupation states he worked as an agent. The verso of the application states he was admitted on October...
Overview Application for admittance to JCRS filled out by hand in ink for David Gordon. Information on the form includes his age, place of birth, occupation, residence, marital status, children's ages, previous stays at hospitals, nearest relatives, and is signed by David Gordon. At the bottom of the page is a section entitled "Recommendation" which is left blank. The back of the form has a section entitled "Report of the Medical Examiner," which states the exam took place March 20, 1909 and found the...