Death Records and CertificatesHeld by an archive
1916 Pennsylvania Certificate of Death – August Reichert, Philadelphia
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
Transcription of: 1916_Death_Record_August_Reichert.pdf
Document: Photocopy of a Commonwealth of Pennsylvania, Department of Health, Bureau of Vital Statistics Certificate of Death (Form V. S. No. 5.–B.), filled in by hand, with stamped file and registered numbers and a faint 'filed' date stamp.
Conventions: original spelling kept; [?] = uncertain reading; [illegible] = unreadable; bracketed italic text describes images or marks the transcriber's notes.
Transcription
Form V. S. No. 5.–B.–25m-2-16-15.
CERTIFICATE OF DEATH. Commonwealth of Pennsylvania. DEPARTMENT OF HEALTH Bureau of Vital Statistics.
| 1. Place of death – County of | PHILADELPHIA |
| City of | PHILADELPHIA |
| Registration District No. | 1 |
| File No. | [Stamp: 68736] |
| Registered No. | [Stamp: 14508] |
| Hospital or Institution | Philadelphia |
| 2. Full name | August Reichert |
PERSONAL AND STATISTICAL PARTICULARS
<table> <colgroup> <col style="width: 23%" /> <col style="width: 76%" /> </colgroup> <tbody> <tr class="odd"> <td><strong>3. Sex</strong></td> <td>Male</td> </tr> <tr class="even"> <td><strong>4. Color or race</strong></td> <td>White</td> </tr> <tr class="odd"> <td><strong>5. Single, married, widowed or divorced</strong></td> <td>Widower</td> </tr> <tr class="even"> <td><strong>6. Date of birth (Month / Day / Year)</strong></td> <td>1 / 18 / 1847</td> </tr> <tr class="odd"> <td><strong>7. Age</strong></td> <td>69 yrs. 4 mos. 2 ds.</td> </tr> <tr class="even"> <td><strong>8. Occupation (a) Trade, profession, or particular kind of work</strong></td> <td>Baker</td> </tr> <tr class="odd"> <td><strong>9. Birthplace (State or Country)</strong></td> <td>Germany</td> </tr> <tr class="even"> <td><strong>10. Name of father</strong></td> <td>——</td> </tr> <tr class="odd"> <td><strong>11. Birthplace of father</strong></td> <td>"</td> </tr> <tr class="even"> <td><strong>12. Maiden name of mother</strong></td> <td>——</td> </tr> <tr class="odd"> <td><strong>13. Birthplace of mother</strong></td> <td>"</td> </tr> <tr class="even"> <td><strong>14. The above is true to the best of my knowledge. (Informant)</strong></td> <td>Wm Schultz</td> </tr> <tr class="odd"> <td><strong>(Address)</strong></td> <td>727 Ritner St</td> </tr> <tr class="even"> <td><strong>15. Filed</strong></td> <td>[Stamp: JUN 23 1916]</td> </tr> <tr class="odd"> <td><strong>Local Registrar</strong></td> <td>John A. O'Neill<br /> Dep</td> </tr> </tbody> </table>
MEDICAL CERTIFICATE OF DEATH
| 16. Date of death (Month / Day / Year) | 6 / 20 / 1916 |
| 17. I hereby certify, that I attended deceased from | 6-14-1916, to 6-20-1916, |
| that I last saw h[im] alive on | 6-20-1916, |
| and that death occurred, on the date stated above, at | 5.30 P. M. |
| The cause of death was as follows | Arthritis Deformans |
| [Handwritten number above cause of death] | 48 |
| (Signed) ... M. D. | A. G. Francis [?] |
| Date signed | 6/21 1916 |
| (Address) | Phila. Hospt. |
| 18. Length of residence – At place of death | yrs. [blank] 1 mos. 21 ds. |
| Former or usual residence | 727 Ritner St |
| Ward | 39 [?] |
| 19. Place of burial or removal | Fernwood |
| Date of burial | 6/23 1916 |
| 20. Undertaker | C. F. Gauker [?] |
| Address | 2141 [?] S. 12th [?] St |
Transcriber's Notes
Physician's signature read as 'A. G. Francis [?]'; it is a scrawl.
Undertaker's name and address are very faint: 'C. F. Gauker [?]', '2141 [?] S. 12th [?] St'.
Ward number beside former residence is faint: '39 [?]' (could be 34).
Local Registrar signature read as 'John A. O'Neill' with 'Dep' beneath.
The '48' written above the cause of death appears to be a later code number.
The filed date stamp is faint: read as JUN 23 1916.