Death Certificate of Annie Mailahn

Case File: Mailahn Family

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

Certificate No 90 (01135)

1. Full name of deceased = Annie Mailahn
2. Maiden name (if wife or widow), = (blank)
3. Color and sex, = White . Female
4. Race, = Caucasian
5. Occupation of deceased = Housework
6. Age (years, months and days), = 25 years, 7 mo, 16 dys
7. Name of father, = Louis Mailahn
8. Birthplace of father = Germany
9. Name of mother, = Gustie Schmidt
10. Birthplace of mother = Wisconsin
11. Birthplace of deceased = Town Black Creek
12. Date of birth of deceased = July 20 - 1820 [note, year 1820 is clearly a clarical error, was 1880]
13. Condition (single, married, widowed, or divorced, = Single
14. Name of wife or husband of deceased = (blank)
15. Date of death, = Mar. 16. 1906
16. Cause of Death {Primary, Secondary} = Phthisis Pulmonalis (Consumption) Heart Failure
17. Duration of disease = One year
18. Place of death = At home
19. Residence at time of death = Town Center
20. Was deceased ever a U. S. solider or sailor? = (blank)
21. Name of physician, coroner or justice, = E. N. Lartell M.D.
22. Residenc of such person = Black Creek, Wis.
23. Name of undertaker or other person conducting burial = Rev. Hinnenthal
24. No. and date of burial permit = 11 - March 17th 1906
25. Place of burial = Town Cemetery Black Creek
26. Date of certificate = March 18th 1906
27. Date of registration = March 21st 1906
28. Other important facts not related = (blank)