Death Certificate of Lizzie Mailahn
From Death Records of Outagamie County, Wisconsin - Vol 3 (Pre Oct 1907)
Certificate No 120 (01860)
# | Question | Answer |
---|---|---|
1 | Full name of deceased | Lizzie Mailahn |
2 | Maiden name (if wife or widow) | |
3 | Color and sex | whtie - female |
4 | Race | Caucasian |
5 | Occupation of deceased | Housework |
6 | Age (years, months and days) | 14 yrs, 9 mos, 18 Dys |
7 | Name of father | Louie Mailahn |
8 | Birthplace of father | Germany |
9 | Name of mother | Augusta Mailahn |
10 | Birthplace of mother | Germany |
11 | Birthplace of deceased | Town of Ellington |
12 | Date of birth of deceased | May 19, 1892 |
13 | Condition (single, married, widowed, or divorced) | Single |
14 | Name of wife or husband of deceased | |
15 | Date of death | March 7th, 1907 |
16 | Cause of death {Primary, Secondary | Phthisis, Heart Failture |
17 | Duration of disease | Several months |
18 | Place of death | at home |
19 | Resdience at time of death | Town Ellington |
20 | Was deceased ever a U. S. soldier or sailor? | |
21 | Name of physician, coroner or justice. | E. N. Sartell, M.D. |
22 | Residence of such person | Black Creek, Wis. |
23 | Name of undertaker or other person conducting burial. | Rev. R. Hinnenthal |
24 | No. and date of burial permit | 20 - March 9th 1907 |
25 | Place of burial | Town Cemetery Black Creek |
26 | Date of certificate | March 8th 1907 |
27 | Date of registration | Apr 26 1907 |
28 | Other important facts not related |