Application of Linna Teplisca to JCRS, 1905 August 10

Item

Identifier: B002.01.0097.0069.00002

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for Linna Teplisca and dated August 10, 1905. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, and signed Linna Teplisca. The back of the form has sections titled "Report of Medical Advisory Board," blank, and "Report of Executive Committee," blank. The middle section of the back is a form filled out by hand. It reads, "No. 122, Case #64, Application of Linna Teplisca, Aug. 10/05, Date of Admission August 30, 1905, Date of leaving June 13, 1906. Handwritten below: [Illegible] May 1, 06, 3-28-06. Died July 10/10. Buried in Rose Hill Cemetery.

Dates

1905 August 10

Creator

Jewish Consumptives' Relief Society (U.S.) (Recipient, Organization)

Rights and Usage Statement

This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). http://rightsstatements.org/vocab/InC-EDU/1.0/

Extent

1 Items (application)

Additional Description

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 30 x 22 centimeteres

General

reformatted digital

Title supplied by archivist.

Inscription and Marks

Handwritten across the top of the front side, "Rec'd Aug 10 1905, ad." Written at the top of the middle section on the back, " 68 (crossed out), case #64."