Obit:
Shoemaker, Duance Edmond
Contact: stan@wiclarkcountyhistory.org
Surnames: Shoemaker, Cole, Field
----Source: Butler Township, Clark County, Wis. Death Records
1 Place of Death County: Clark Township: Butler Village: City:
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STATE OF WISCONSIN Department of Health - Bureau of Vital Statistics Original Certificate of Death Registered No: 1
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2 FULL NAME: Duance Edmond Shoemaker |
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Personal and Statistical Particulars |
Medical Certificate of Death |
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3 Sex Male |
4 Color White |
5 S/M/W/D Single |
16 Date of Death (M/D/Y) Oct 10, 1918 |
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6 Date of Birth (M/D/Y) January 23, 1917 |
17 I HERBY CERTIFY, That I attended deceased from Oct 7, 1918 to Oct 10, 1918 that I saw him alive on Oct 10, 1918 and that death occurred on the date above, at 6-10 PM The cause of death was as follows:
Cold and influenza.
Signed: B. A. Cole Date: Oct 10, 1918 Thorpe, Wis. |
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7 Age (Yrs/Mos/Ds/Hrs/Min) 1/8/17 |
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8 Occupation
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9 Birthplace Butler Clark Co., Wisc |
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10 Name of Father Carl Lincoln Shoemaker |
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11 Birthplace of Father Greenwood, Wisc. |
18 Length of Residence (Hospitals, etc.)
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12 Maiden Name of Mother Olive Velma Langley |
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13 Birthplace of Mother Greenwood, Wisc. |
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14 The above is true to the best of my knowledge Informant: B. A. Cole, M. D. Address: Thorpe, Wisc. |
19 Place of burial or removal Butler Cemetery |
Date Oct 12, 1918 |
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15 File date - Registrar Oct 12 1918 - Arthur J. Field
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20 Undertaker Person in charge B. A. Cole, M. D. |
Address Thorpe, Wis. |
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