----Source: Wisconsin State Records

Maria (Gerken) HINKE certificate of death

Wisconsin State Board of Health Certificate of Death Local Registrar's No. 412

1. Place of Death: a. County: Clark b. City or Town: Owen c. Length of stay: (blank) d. Full name of Hospital or institution: Havenet Home
2. Usual residence: a. State: Wisconsin b. County: Clark c. City or Town: Mayville d. Street address: (blank)
3. Name of deceased: a. First: Maria b. Middle: (blank) c. Last: Hinke
4. Date of death: m/d/y 2-3-1959 5. Sex: Female 6. Color or race: White 7. Widow 8. Date of Birth: Dec. 17, 1873 9. Age (in years): 86 years 1 month 17 days 10. Usual occupation: (blank) 11. Birthplace: Germany 12. Citizen of what country: U.S. 13. Father's name: John Gerken 14. Mother's maiden name: unknown 15. Was deceased ever in U.S. armed forces: (blank) 16. Social Security Number: (blank) 17. Informant: Chas. Hinke
18. Cause of death: a. immediate cause: Hypostatic pneumonitis b. due to: Rarent Right Hip FX (1 year approx) c. due to: Gen. Artersclerosis
19. Was autopsy performed: No
20. a. Accident/Suicide/Homicide (all left blank) b. Place of injury (blank) c. City, Town or Township/County/State: Owen, Clark, Wis.
21. Attendance of the deceased: (all left blank)
22. a. Signature: H.M. Braswell, Jr. M.D. b. address: Owen, Wis. c. Date signed: 2-3-59
23. a. Burial, Cremation, Removal: Burial b. Date: 2-6-59 c. Name of cemetery or crematory: Memorial d. Location: Dorchester, Wis.
Date Recorded by Local Reg. 2-19-59 Registrar's signature: (illegible)
24. Funeral director: Edward J. Fuchgruber, Dorchester, Wis.