Editing Death Certificate of Mrs. Bertha Welch

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

Certificate No 01062

# Full name of deceased                                 = Mrs. Bertha Welch
# Maiden name (if wife or widow),                       = Bertha Mailahn
# Color and sex,                                        = White . Female
# Race,                                                 = Caucasian
# Occupation of deceased                                = Housework
# Age (years, months and days),                         = 25 years, 4 mo, 1 day
# Name of father,                                       = [[Louis Mailahn]]
# Birthplace of father                                  = Germany
# Name of mother,                                       = [[Augusta Schmidt Mailahn|Gusta Mailayn]]
# Birthplace of mother                                  = Wisconsin
# Birthplace of deceased                                = Black Creek
# Date of birth of deceased                             = July 20 1880
# Condition (single, married, widowed, or divorced,     = Married
# Name of wife or husband of deceased                   = Jessie Welch
# Date of death,                                        = Nov 21 1905
# Cause of Death {Primary, Secondary}                   = Tubercular abcess - Tuberculosis of lungs
# Duration of disease                                   = about 2 months
# Place of death                                        = Black Creek
# Residence at time of death                            = Black Creek
# Was deceased ever a U. S. solider or sailor?          = (blank)
# Name of physician, coroner or justice,                = J. J. Laird
# Residenc of such person                               = Black Creek
# Name of undertaker or other person conducting burial  = Gus Strassburger
# No. and date of burial permit                         = 6 - Nov 21 1905
# Place of burial                                       = Black Creek Cemetery
# Date of certificate                                   = Nov 21 1905
# Date of registration                                  = Nov 24 1905
# Other important facts not related                     = (blank)