<P> In the mid-19th century, both Randalls and Wards Islands, like nearby Blackwell's Island became home to a variety of social facilities . Randalls housed an orphanage, poor house, burial ground for the poor, "idiot" asylum, homeopathic hospital and rest home for Civil War veterans, and was also site of the New York House of Refuge, a reform school completed in 1854 for juvenile delinquents or juveniles adjudicated as vagrants . Between 1840 and 1930, Wards island was used for: </P> <Ul> <Li> Burial of hundreds of thousands of bodies relocated from the Madison Square and Bryant Park graveyards </Li> <Li> The State Emigrant Refuge, a hospital for sick and destitute immigrants, opened in 1847, the biggest hospital complex in the world during the 1850s </Li> <Li> The New York City Asylum for the Insane, opened around 1863 </Li> <Li> Manhattan Psychiatric Center (incorporating the Asylum for the Insane), operated by New York State when it took over the immigration and asylum buildings in 1899 . With 4,400 patients, it was the largest psychiatric institution in the world . The 1920 census notes that the hospital had a total of 6,045 patients . It later became the Manhattan Psychiatric Center . </Li> </Ul> <Li> Burial of hundreds of thousands of bodies relocated from the Madison Square and Bryant Park graveyards </Li> <Li> The State Emigrant Refuge, a hospital for sick and destitute immigrants, opened in 1847, the biggest hospital complex in the world during the 1850s </Li>

What is the big building on randall's island