Death Certificate - Joseph Bloemer (1912)
Title | Death Certificate - Joseph Bloemer (1912)
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Text | CERTIFICATE AND RECORD OF DEATH OF
- Full Name: Joseph Bloemer
- (a) Sex: Male (b) Color: White (c) Single Married Widowed Divorced: Married
- (a) Birthplace: Germany (b) Date of Birth:
- Age 78 Years - Month - Days __ Hours (If less than One Day old)
- Died on the 8 Day of Feb 1912 at about 5 AM
- Last Occupation: Farmer (Profession, Trade or Kind of Industry or Business)
- { From Year __ To Year __
Previous Occupation (if any) __
From __ To __
- Place of Death: Effingham (Township, Village or City) County of Effingham
** Second Column **
Registered No. __
Effingham County
- How long in State: 40 Years
- How long in U.S. if Foreign born __
- { (a) Name of Father __
(b) Birthplace of Father __
- { (a) Maiden Name of Mother __
(b) Birthplace of Mother __
The foregoing stated personal particulars are true to the best of my knowledge and belief
- Informant __
Address __
** Only one column now **
- Place of Burial St. anthonys cem
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Unique identifier | 24B69897C211467187B0F8ADC8B200341D10
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Last change | July 20, 2020 – 08:17:03
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