REGISTRATION OF DEATHS

NEILLSVILLE CLARK CO., VOL 1, 1870-1879

(pg. 5)

1. Full name of deceased: Johnson, Knuy
2. Color: white
3. Sex: male
4. Age: twenty three
5. Name of the father of deceased: not known
6. Name of the mother of deceased: not known
7. Occupation: laborer
8. Place of Birth: Norway
9. Name of wife of deceased: single man
10. Name of husband of deceased:
11. Date of birth and date of death: Birth not known, death-Dec. 1st 1876
12. Cause of death: by falling of a limb from a tree striking him on the temple.
13. Name of the place,
town or township, and county,
in which the person died: Colby, Clark Co., Wis.
14. Name and location of burial ground
in which interred:
15. Name of person returning certificate: Wm. Stewart
16. Residence of such person: Unity, Marathon Co., Wis.
17. Date of certificate: Dec. 8, 1876
18. Date of Registration: Dec. 26, 1876

Transcribed by Janet.