Death Records and CertificatesHeld by an archive
Transcription
Transcript
Uncertain readings are marked [?] or set in brackets; words that could not be read are marked as such. Each transcript is shown as written, with its transcriber’s notes.
The record
Document: One page: Commonwealth of Pennsylvania certificate of death (Form V. S. No. 5) for Fredericka Wesemann, Philadelphia.
Language: English
Transcription conventions: on printed forms, pre-printed text is set in roman and handwritten entries in \italic\; wholly handwritten registers and lists are set in roman. Square brackets mark editorial matter: [?] follows an uncertain reading, [illegible] marks unread text, [blank] marks an unfilled field, and bracketed descriptions record stamps, marks, and annotations. Spelling, abbreviation, and capitalisation follow the original; nothing is corrected. On census and register pages that carry many unrelated entries, the page heading and the target household or entry are transcribed in full; the extent of what is and is not transcribed is stated on each page.
FORM V. S. No. 5. COMMONWEALTH OF PENNSYLVANIA. BUREAU OF VITAL STATISTICS. CERTIFICATE OF DEATH.
PLACE OF DEATH. County of [blank; stamped PHILA.] Township of [blank] or Borough of [blank] or City of [blank] Registration District No. [blank] Primary Registration District No. [blank] File No. 60913 Registered No. 16320
(No. 2304 E. Firth St.; 31st Ward) [If death occurred in a Hospital or Institution, give its NAME instead of street and number.]
[If death occurs away from USUAL RESIDENCE give facts called for under “Special Information.”] FULL NAME Fredericka Wesemann
Personal and statistical particulars
| Field | Entry |
| SEX | F |
| COLOR | W |
| DATE OF BIRTH (Month) (Day) (Year) | 5 | 23 | 1844 |
| AGE | 63 years, — months, 26 days |
| SINGLE, MARRIED, WIDOWED, OR DIVORCED | Wd. |
| BIRTHPLACE (State or country) | Ger. |
| NAME OF FATHER | [dash] |
| BIRTHPLACE OF FATHER (State or country) | Ger. |
| MAIDEN NAME OF MOTHER | [dash] |
| BIRTHPLACE OF MOTHER (State or country) | Ger. |
| OCCUPATION | [dash] |
| THE ABOVE STATED PERSONAL PARTICULARS ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF (Informant) | [blank] |
| (Address) | [blank] |
| Filed … 190 … | [blank] [signature, illegible], Registrar |
Medical certificate of death
DATE OF DEATH June (Month) 18 (Day) 190*7* (Year)
I HEREBY CERTIFY, That I attended deceased from … 190 … to … 190 …, that I last saw h… alive on … 190…, and that death occurred, on the date stated above, at … M. [all blank; a diagonal stroke through the lines]
The CAUSE OF DEATH was as follows: Heart disease [pencil:] 202 (Duration) … Days
Contributory [blank] (Duration) … Days
(Signed) J. M. K. Jermon M.D. [overwritten] Cor. … 190 … (Address) [blank]
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or Recent Residents. Former or Usual Residence [blank]. How long at Place of Death? … Days. Where was disease contracted? [blank]
PLACE OF BURIAL OR REMOVAL Hillside DATE OF BURIAL 6.22. 190*7*
UNDERTAKER C. Carlin ADDRESS 4536 Girard Ave
[Printed vertically in left margin:] WRITE PLAINLY, WITH UNFADING INK—THIS IS A PERMANENT RECORD. N. B.—Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, that it may be properly classified. The “Special Information” for persons dying away from home should be given in every instance.
Transcriber’s notes
The date of death reads June 18; it agrees with the age at death (63 years 26 days from 23 May 1844). Birth date 23 May 1844 agrees exactly with her baptism.
The certificate was signed by the coroner (“Cor.”) with the attendance section struck through, which indicates she was not under a physician’s care at death; a coroner’s record may exist.
Parents’ names are left blank. Burial at Hillside Cemetery, 22 June 1907, matches the family tradition (Hillside Cemetery, Roslyn).
Grade: PRIMARY for the death; birth data informant-supplied.