Archive Record
Images
Metadata
Catalog Number |
2018.46.81 |
Accession number |
2018.46 |
Object Name |
Form |
Title |
Student's History Blank for Leonard Chase |
Date |
1887 Apr 5 |
Scope & Content |
Student's History Blank for Leonard Chase; 1887 Apr 5. Student history form filled out for Leonard Chase, form has personal history information headings printed on it in black ink and answers handwritten in black ink, top of the form reads "STUDENT'S HISTORY BLANK." with "F-5" and "145" handwritten above it in black ink, two hole punches in the top edge; 13.9 cm (w) x 21.5 cm (h). Paper yellowing, corners worn, bottom right and both left corners bent, paper bent in places, three horizontal creases from folding, bending and tearing around the hole punches, brown spots and stains, black marks and smudges. |
Credit line |
Museum of Osteopathic Medicine |
People |
Chase, Leonard |
Search Terms |
Academy Accidents Age Agent Singer Manufacturing Company American School of Osteopathy ASO Attended Church College Date Denomination Farmer City High School Farmer City, Illinois Graduated High School Husband Lawrenceburg, Indiana Married Medical School Name Nationality Nurses School Place of Birth Previous Occupation Pupil Recovered Residence School Serious Illness Single Students History Blank University Wife |