Jennie Louise Hansen (Death Certificate)

WISCONSIN STATE BOARD OF HEALTH 
ORIGINAL CERTIFICATE OF DEATH # 0026734 
NAME OF DECEASED: Jennie L. Emerson
PLACE OF DEATH:  1214 Center ST.
Racine, Racine County
USUAL RESIDENCE:  1214 Center St.
Racine, Wisconsin
SEX: Female
COLOR OR RACE: White
MARITAL STATUS: Married
DATE OF BIRTH: December 20, 1866
PLACE OF BIRTH: Racine County, Wisconsin
AGE: 85 Years
KIND OF BUSINESS: Housewife
FATHER'S NAME: William J. Howard
MOTHER'S MAIDEN NAME: Edith Dawson
INFORMANT: Elmer Emerson, Husband
DATE OF DEATH: December 15, 1952
CAUSE OF DEATH:  Bronchitis and Chronic
Myocarditis
ANTECEDENT CAUSES:  Secondary Anemia
Weakness-wouldn't eat
CERTIFICATION:         I hereby certify that I attended
the deceased from August, 1952 to
December 15, 1952, that I last saw
the deceased alive on December 12,
1952, and that death occurred at 4
P.M., from the cause and on the
date stated above.
PHYSICIAN:  H. J. Brehm, Sr.
1401 Grand Avenue
BURIAL:  Calvary Cemetery
Racine, Wisconsin
DATE OF BURIAL: December 18, 1952
FUNERAL DIRECTOR:  Dan Strouf
Racine, Wisconsin

Related Biographies:

Jennie Louise Hansen

Acknowledgements

Phillip Gowan

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Copyright © 1996-2019 Encyclopedia Titanica (www.encyclopedia-titanica.org) and third parties (ref: #21031, published 28 August 2003, generated 15th November 2019 06:23:41 PM)
URL : https://www.encyclopedia-titanica.org/death-certificate-21031-194.html