Application of I. Pearlman (Isaac Pearlman) to JCRS, 1904 October 10

Item

Identifier: B002.01.0097.0191.00001

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for I. Pearlman and is dated Nov 1 1905. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed I. Pearlman. 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. 3 (crossed out) 21 (crossed out) 21 (crossed out) 31, Case #21 (crossed out) 76, Case 186 #31,, Application of I. Pearlman, Oct 10/04, Date of Admission, November 8 1905, Date of Discharge,April 23 1906, Disch May 1st 3-28-06 (underlined) Readmitted as Emergency Sept 3, 1906, Died Suddenly Sept. 13, 1906 Curied in Mount Nebo Cemetery 9/14/06 Sec L. Lot 61/2 (handwritten)."

Dates

1904 October 10

Creator

Jewish Consumptives' Relief Society (U.S.) (Producer, 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 31 x 22 centimeters

General

reformatted digital

title supplied by archivist

Inscription and Marks

Handwritten in pencil, at top of page: "called and asked to be admitted 9-22-05, 36 (underlined)." Handwritten in black ink, at top of page: "31, Reced Oct 10, 1904." Stamped in blue ink, at top right-hand corner: "received Oct 10/ 05 (crossed out) 04, Accepted Nov 1/05, Admitted Nov 8, 05, Discharged Apr 23/06, Left, Died." Handwritten in red ink, at bottom of page: "Readmitted as Emergency Sept. 3, 1906 Died suddenly Sept. 13, 1906." Handwritten in pencil, at bottom left-hand corner: "admitted."