Confidential inquiry sheet and Voucher
1902-01-04 1902 1900s 3 pages GREAT NORTHERN CENTRAL HOSPITAL. CONFIDENTIAL INQUIRY SHEET. Name Age S. M. W. Address Children, or other Dependents Wages________________ If out of work, and how long_________________ Amount from Club_______________________________Extra,...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
| Published: |
4 January 1902
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/BF14281C-C16A-44C7-8BD3-2E6EFE3EF38A http://hdl.handle.net/10796/23E75192-3EDD-4B5E-B616-18E79E415D14 |
| Summary: | 1902-01-04
1902
1900s
3 pages
GREAT NORTHERN CENTRAL HOSPITAL. CONFIDENTIAL INQUIRY SHEET. Name Age S. M. W. Address Children, or other Dependents Wages________________ If out of work, and how long_________________ Amount from Club_______________________________Extra, from gratuities Earnings of Wife, or Children Rents from Lodgers How long ill_________________________________________ Whether incapacitated by illness__________ If under previous treatment__________________________ Private or Hospital Doctor's Name Address Whether Member of Provident Dispensary , or Club Name of Club and Doctor Rent of Dwelling House or Lodgings Other information Date of Inquiry 189
378/IMSW/A/1/6/9a |
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| Physical Description: | TEXT |