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)

#	Question	Answer
1	Full name of deceased	Annie Mailahn
2	Maiden name (if wife or widow)
3	Color and sex	White . Female
4	Race	Caucasian
5	Occupation of deceased	Housework
6	Age (years, months, 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 - 1880
13	Condition (single, married, widowed, or divorced)	Single
14	Name of wife or husband of deceased
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. soldier or sailor
21	Name of physician, coroner or justice	E. N. Lartell, M.D.
22	Residence 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	Tome Cemetery Black Creek
26	Date of certificate	March 18th 1906
27	Date of registration	March 21st 1906
28	Other important facts not related