Editing Death Certificate of Mrs. Bertha Welch

<b>[[Case File: Mailahn Family]]</b>

From Death Records of Outagamie County, Wisconsin - Vol 3 (Pre Oct 1907)

Certificate No 01062

{| class="wikitable"
|+
!#
!Question
!Answer
|-
|1
|Full name of deceased
|Mrs. Bertha Welch
|-
|2
|Maiden name (if wife or widow)
|[[Bertha Mailahn]]
|-
|3
|Color and sex
|White Female
|-
|4
|Race
|Caucasian
|-
|5
|Occupation of deceased
|Housework
|-
|6
|Age (years, months and days)
|25 years, 4 mo, 1 day
|-
|7
|Name of father
|[[Louis Mailahn]]
|-
|8
|Birthplace of father
|Germany
|-
|9
|Name of mother
|[[Augusta Schmidt Mailahn|Gusta Mailayn]]
|-
|10
|Birthplace of mother
|Wisconsin
|-
|11
|Birthplace of deceased
|Black Creek
|-
|12
|Date of birth of deceased
|July 20 1880
|-
|13
|Condition (single, married, widowed, or divorced)
|Married
|-
|14
|Name of wife or husband of deceased
|Jessie Welch
|-
|15
|Date of death
|Nov 21 1905
|-
|16
|Cause of Death {Primary, Secondary}
|Tubercular abcess - Tuberculosis of lungs
|-
|17
|Duration of disease
|about 2 months
|-
|18
|Place of death
|Black Creek
|-
|19
|Resident at time of death
|Black Creek
|-
|20
|Was deceased ever a U.S. soldier or sailor?
|
|-
|21
|Name of physician, coroner or justice
|J. J. Laird
|-
|22
|Residence of such person
|Black Creek
|-
|23
|Name of undertaker or other person conducting burial
|Gus Strassburger
|-
|24
|No. and date of burial permit
|6 - Nov 21 1905
|-
|25
|Place of burial
|Black Creek Cemetery
|-
|26
|Date of certificate
|Nov 21 1905
|-
|27
|Date of registration
|Nov 24 1905
|-
|28
|Other important facts not related
|
|}