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Application of Harry Weber to JCRS, 1906 May 12

 Item
Identifier: B002.01.0097.0143.00003

Abstract

Application for admittance to JCRS filled out by hand for Harry Weber and is dated May 12, 1906. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed Harry Weber. The back of the form has sections titled "Report of Medical Advisory Board" and "Report of Executive Committee," both are blank. The middle section of the back is a form filled out by hand. It reads, "No. 226, Case #159 (crossed out) 156, Application of, Harry Weber, May 12/06, Date of Admission, June 15 1906, Date of Discharge (crossed out) Leaving, Aug 17 1906."

Dates

  • 1906 May 12

Creator

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)

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

reformatted digital

title supplied by archivist

Inscription and Marks

Handwritten in pencil, at top right-hand corner: "May 12, 1906." Stamped in blue ink, at bottom left-hand corner: "Received May 12 1906, Accepted June 14, 1906, Admitted June 15, 06, Discharged, Left Aug 17, 06, Died."

Repository Details

Part of the Special Collections and Archives Repository

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