1924 Pennsylvania Certificate of Death – Christian Weiss, Philadelphia General Hospital

The record

Transcription of: 1924_Death_Record_Christian_Weiss.pdf

Document: Photocopy of a Commonwealth of Pennsylvania, Department of Health, Bureau of Vital Statistics Certificate of Death (Form V. S. No. 5B), filled in by hand, with stamped file and registered numbers, a filed date stamp, and later handwritten numbers and a margin note.

Conventions: original spelling kept; [?] = uncertain reading; [illegible] = unreadable; bracketed italic text describes images or marks the transcriber's notes.

Transcription

Form V. S. No. 5B 25M-7-3-23.

CERTIFICATE OF DEATH COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH BUREAU OF VITAL STATISTICS

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>Married</td> </tr> <tr class="even"> <td><strong>5a. If married, widowed, or divorced, husband of (or) wife of</strong></td> <td>Husband of Charlotte Weiss</td> </tr> <tr class="odd"> <td><strong>6. Date of birth (month, day, and year)</strong></td> <td>Feb. 14. 1859</td> </tr> <tr class="even"> <td><strong>7. Age</strong></td> <td>65. Years 5. Months 1. Days</td> </tr> <tr class="odd"> <td><strong>8. Occupation of deceased (a) Trade, profession, or particular kind of work</strong></td> <td>Blacksmith</td> </tr> <tr class="even"> <td><strong>9. Birthplace (State or country)</strong></td> <td>Germany</td> </tr> <tr class="odd"> <td><strong>10. Name of father</strong></td> <td>Dont Know</td> </tr> <tr class="even"> <td><strong>11. Birthplace of father (State or country)</strong></td> <td>Germany</td> </tr> <tr class="odd"> <td><strong>12. Maiden name of mother</strong></td> <td>Dont Know</td> </tr> <tr class="even"> <td><strong>13. Birthplace of mother (State or country)</strong></td> <td>Germany</td> </tr> <tr class="odd"> <td><strong>14. Informant</strong></td> <td>Theodore Boehnlein</td> </tr> <tr class="even"> <td><strong>(Address)</strong></td> <td>4474 Fleming St Manayunk Pa.</td> </tr> <tr class="odd"> <td><strong>15. Filed</strong></td> <td>[Stamp: JUL 16 1924]</td> </tr> <tr class="even"> <td><strong>Registrar</strong></td> <td>T. E. Rowbotham<br /> sub</td> </tr> </tbody> </table>

11–3184

MEDICAL CERTIFICATE OF DEATH

<table> <colgroup> <col style="width: 23%" /> <col style="width: 76%" /> </colgroup> <tbody> <tr class="odd"> <td><strong>16. Date of death (Month / Day / Year)</strong></td> <td>7 / 15 / 1924</td> </tr> <tr class="even"> <td><strong>17. I hereby certify, that I attended deceased from</strong></td> <td>7 1, 1924, to 7 15, 1924</td> </tr> <tr class="odd"> <td><strong>that I last saw h[im] alive on</strong></td> <td>7 15, 1924</td> </tr> <tr class="even"> <td><strong>and that death occurred, on the date stated above, at</strong></td> <td>11.25 P.m.</td> </tr> <tr class="odd"> <td><strong>The cause of death was as follows</strong></td> <td>Arteriosclerosis</td> </tr> <tr class="even"> <td><strong>[Handwritten code numbers below cause of death]</strong></td> <td>84 [crossed out] 92-90</td> </tr> <tr class="odd"> <td><strong>Contributory (secondary)</strong></td> <td>Myocardial degeneration</td> </tr> <tr class="even"> <td><strong>Did an operation precede death?</strong></td> <td>No</td> </tr> <tr class="odd"> <td><strong>Was there an autopsy?</strong></td> <td>No</td> </tr> <tr class="even"> <td><strong>What test confirmed diagnosis?</strong></td> <td>None</td> </tr> <tr class="odd"> <td><strong>(Signed) ... M. D.</strong></td> <td>J. W. Frazier</td> </tr> <tr class="even"> <td><strong>Date signed</strong></td> <td>7/16/24</td> </tr> <tr class="odd"> <td><strong>(Address)</strong></td> <td>Phila, Gen. Hosp</td> </tr> <tr class="even"> <td><strong>[Margin, right side, written vertically]</strong></td> <td>Admitted 6-26-24</td> </tr> <tr class="odd"> <td><strong>19. Place of burial, cremation or removal</strong></td> <td>Leverington Cem. Rox.</td> </tr> <tr class="even"> <td><strong>Date of burial</strong></td> <td>July 18, 1924</td> </tr> <tr class="odd"> <td><strong>20. Undertaker</strong></td> <td>John Strittmatter</td> </tr> <tr class="even"> <td><strong>Address</strong></td> <td>4327 Cresson st<br /> Manayunk</td> </tr> </tbody> </table>

Transcriber's Notes

Informant's surname read as 'Boehnlein'; the ink is faint.

Registrar's signature read as 'T. E. Rowbotham'; the abbreviation under it reads 'sub' (re-checked at zoom 2026-09-27).

Physician's signature read as 'J. W. Frazier'.

File No. stamp is faint: read as 73651.

The '71' near the top and the numbers '84' (crossed out) and '92-90' in the cause-of-death area are later annotations.

Cause of death written as a single word, read as 'Arteriosclerosis'.