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 for admittance form with only the middle section of the back of the form filled out. Middle section on back reads "Application No. 1284. Case No. 977. Application of Rosa Jolitzky. Address 1440 - Knox Court. Received Nov 24 1909. Admitted Feb 4 1910. Left January 24/11."
Dates: 1909 November 24-1911 January 24
Overview Application for admission to JCRS filled out by hand in ink for Rosa Jolitzky. Information on the form includes age, birth place, occupation, residence, marital status, children's ages, and nearest relatives. Form is signed in yiddish. Nearest relative is listed as "Abr. Jolitzky (husband) 383 W. 14th St. Chigo." In the Recommendation section at the bottom of the page reads "Mr Sam Roatman 1440 Knox Court." The section "Report of the Medical Examiner" on the back side of the form states...
Dates: 1909 November 24