Sarah Ann Cole

Butler Township, Clark Co., Wisconsin

 

 

1 Place of Death

County:  Clark

Township:  Butler

Village: 

City: 

 

 

STATE OF WISCONSIN

Department of Health – Bureau of Vital Statistics

Original Certificate of Death

                                                Registered No:  1

 

2 FULL NAME:  Sarah Ann Cole

Personal and Statistical Particulars

Medical Certificate of Death

3 Sex

Female

4 Color

White

5 S/M/W/D

Widowed

16 Date of Death (M/D/Y)

Dec 21, 1926

6 Date of Birth (M/D/Y)

Apr 24,  1829

17 I HERBY CERTIFY, That I attended deceased from

 

that I saw her     alive  on Dec 21, 1926

and that death occurred on the date above, at 2:30 PM

The cause of death was as follows:  Senile debility and has been

Lingering for years.

 

 

Signed:  B. A. Cole, M. D.,, Thorp

Date: 

7 Age (Yrs/Mos/Ds/Hrs/Min)

97/7/27

8 Occupation

Housewife

9 Birthplace

Randolph, Portage Cp.

10 Name of Father

Beden Goss

11 Birthplace of Father

 

18 Length of Residence (Hospitals, etc.)

 

12 Maiden Name of Mother

Phidelia Cross

13 Birthplace of Mother

Vermont

14 The above is true to the best of my knowledge

Informant:  B. A. Cole, M. D.

Address:  Thorp

19 Place of burial or removal

Woodstock, Wis.

Date

Dec 24, 1926

15  File date - Registrar

Dec 22, 1928   H. C. Conklin

 

20 Undertaker

 

Address

 

 

____________________________________________________

THIS “STUB” TO BE KEPT BY PERSON ISSUING PERMIT

 

______

 

BURIAL PERMIT

______

 

1.  Name of deceased:  Sarah Ann Cole

 

2.  Place of burial:  Woodstock, Wis.

 

3.  Date and place of death: Dec 21, ’26; Town of Butler,

Clark Co., Wis.

4.  Disease causing death:  Senile Debility

 

5.  Cause of death given by: 

 

 

6.  Undertaker: 

 

 

 

 

 

Submit a Response

 

**This Clark Co., WI Internet Library, ALHN & AHGP website is dedicated to the free sharing of information by researchers, local historians, genealogists and educators.  Because of our non-profit status, submissions are not to be used for profiteering of any kind.   Our representatives cannot accept gratuities beyond the basic expenses (i.e. postage, copying, courthouse or rental fees) for obtaining requested information.  We reserve the right to ban the involvement of anyone who intentionally disregards these policies.   Please show your appreciation for this database by Becoming a Clark County History Buff or making a contribution to our Support Fund and Perpetual Preservation Account to help keep this Clark Co., WI database freely available on the World Wide Web and free from commercial enterprise.

 

*** This copyrighted Clark Co., Wis. genealogy and history material is used by permission of the submitters.  Contact us if anyone is using this data inappropriately.  It may not be copied and posted to any commercial/.com genealogy sites such as Genealogy Trails, Family Tree Maker or the merged companies Ancestry.Com/RootsWeb/MyFamily or sold for profit.

 

Report Broken Links

ALHN & AHGP HOME PAGE

 

This page is a part of the Clark County, WI Internet Library Project

Every submission is protected by the Digital Millennium Copyright Act of 1998.

~~The Clark Co., Wisconsin History Buffs maintain these pages in support of Free On-line History & Genealogy~~