Application of Annie Brown to JCRS, 1906 August 21

Item

Identifier: B002.01.0097.0197.00002

Staff Only

Abstract

Application for admittance to JCRS filled out by hand for Annie Brown and is dated Aug 21, 1906. Information on the form includes her age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed Annie Brown. 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. 296, no case # identified but the number 22 is handwritten underneath patient number, Application of Annie Brown, Received Aug. 21, 1906, Date of Admission, September 28 1906, Date of Discharge (crossed out) death October 22 1906."

Dates

1906 August 21

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 pen, at top of page: "296." Stamped in blue ink, at bottom left-hand corner: "Received Aug 21 1906, Accepted September 27, 1906, Admitted September 28, 1906, Discharged, Left, Died Oct. 22 1906."