Created by gemini-2.0-flash-lite on 2025-05-04

The image displays a printed form titled "LEAGUE FOR PREVENTIVE WORK - REGISTRY OF FEEBLE-MINDED". It appears to be a historical document used for collecting information about individuals considered "feeble-minded."

The form is divided into several sections designed to gather specific data points, including:

• Personal Information: Name (Surname First), Date and Place of Birth, Residence, Name of Husband (or Wife), Name of Father, and First and Maiden Name of Mother.
• Medical and Observation Details: When Examined, By Whom, Basis of Diagnosis, How Long Under Observation and By Whom, and Diagnosis.
• Institutional Records: Date of Application, Institution, When Admitted, and When Discharged (likely referring to institutional placements). There are also sections for Date of Commitment by Court, Institution, When Admitted, and When Discharged, which further suggests the form was used for tracking individuals who were committed or placed in institutions by the court system.
• Remarks: A space for any additional relevant information.
• Reporting and Case Status: Reported By, Case Active (with options for "Yes" and "No").
• Notes: A section to note if the examiner is a physician or psychologist and a note for when hospital registers are used, including information known to the Social Service Department.

The layout is organized with lines and headings, indicating the form's intended use for recording structured information in a methodical manner. The document's tone and terminology reflect historical societal attitudes regarding intellectual disabilities.

Created by gemini-2.0-flash on 2025-05-04

Here's a description of the image:

The image presents a historical document: a registry card titled "LEAGUE FOR PREVENTIVE WORK - REGISTRY OF FEEBLE-MINDED." The card is structured as a form with labeled blank lines for filling in information related to an individual deemed "feeble-minded."

The form includes the following fields:

• Name (Surname First)
• Date and Place of Birth
• Residence
• Name of Husband (or Wife)
• Name of Father
• First and Maiden Name of Mother
• When Examined
• By Whom
• Basis of Diagnosis
• How Long Under Observation and by Whom
• Diagnosis
• Date of Application
• Institution, When Admitted, When Discharged
• Date of Commitment by Court
• Institution, When Admitted, When Discharged
• Remarks
• Reported By
• A section to indicate if the case is active (Yes/No)
• A note to indicate if the examiner is a physician or psychologist
• A note about hospital registers and social service department knowledge

The language used reflects the terminology and attitudes prevalent during the time the card was likely created, a period when eugenics and institutionalization of individuals with intellectual disabilities were more common. The document provides insight into historical perspectives on intellectual disability and societal efforts related to its management.