State of Wisconsin Department of Health - Bureau of Vital Statistics Copy of Death Record Page number 311

1. Place of Death: Clark County, Mayville Township, Wisconsin 2. Full Name: Claus Hinke 3. Sex: M 4. Color or race: W 5. Married 5a. husband 6. Date of Birth: (left blank) 7. Age: 62 years, 10 months, 5 days 8a. Occupation: Farmer 8b. Farm work 9. Birthplace: Germany 10. Name of father: Claus Hinke 11. Birthplace of father: Germany 12. Maiden name of mother: Gerche Roge 13. Birthplace of mother: Germany 14. Informant: Mrs. C. Hinke address: Abbotsford, Wis. 15. Filed: Oct. 22, 1920 G.R. Broeske (registrar) 16. Date of Death: Oct. 22, 1920 17. Cause of death: Dislocation of ??ast lived 10 minutes contributory: Fell through trap door in barn 18. Signed: G.B. Johnston M.D. Oct. 22, 1920 Abbotsford 19. Place of burial: Dorchester, Wis. date of burial: Oct. 25, 1920 20. Undertaker: ?.J. Meyer address: Abbotsford

Claus HINKE - Death Record

State of Wisconsin Department of Health - Bureau of Vital Statistics Copy of Death Record Page number 311

1. Place of Death: Clark County, Mayville Township, Wisconsin 2. Full Name: Claus Hinke 3. Sex: M 4. Color or race: W 5. Married 5a. husband 6. Date of Birth: (left blank) 7. Age: 62 years, 10 months, 5 days 8a. Occupation: Farmer 8b. Farm work 9. Birthplace: Germany 10. Name of father: Claus Hinke 11. Birthplace of father: Germany 12. Maiden name of mother: Gerche Roge 13. Birthplace of mother: Germany 14. Informant: Mrs. C. Hinke address: Abbotsford, Wis. 15. Filed: Oct. 22, 1920 G.R. Broeske (registrar) 16. Date of Death: Oct. 22, 1920 17. Cause of death: Dislocation of ??ast lived 10 minutes contributory: Fell through trap door in barn 18. Signed: G. B. Johnston M.D. Oct. 22, 1920 Abbotsford 19. Place of burial: Dorchester, Wis. date of burial: Oct. 25, 1920 20. Undertaker: ?.J. Meyer address: Abbotsford