He was born on 2 February 1844, in Philadelphia, Pennsylvania, to William Baley and Harriet [illegible family name].
[sources:
date: 10; 2 (23 in 1864), 3 (23 in 1864), 11 (17 in 1860).
place: 2, 3, 10, 11.
parents: 10; see also 14]
In 1860, he was apparently living in ward 24, Philadelphia, Pennsylvania.
He was living with Harriet (presumably his mother), with William, Henry, Charles, Joseph, Isabella, and Mary (presumably his siblings), along with others.
He was a laborer.
[source: 11]
When he enlisted, he was a whip maker, and was living in Philadelphia, Pennsylvania.
[sources: 2, 3]
Description
When he enlisted, he was 5 feet 5-1/4 inches tall, and had a light complexion, blue eyes, and brown hair.
[sources: 2 (5'5-1/4", light complexion, blue eyes, brown hair), 3 (5'7", light complexion, light eyes, blue hair)]
During the war
He enlisted and was mustered into service on 28 January 1864.
He was enlisted for one year, at Philadelphia, Pennsylvania, by Captain Lane.
He was mustered in as a private at Philadelphia, Pennsylvania.
He was a private in company D.
[sources: 1 (1864), 2 (1864), 3 (28 January 1865), 4 (1 Jan 64), 7 (28 Jan 65), 17, 18]
On 9 October 1865, he and others published an ad in the Philadelphia Inquirer supporting Jacob E Ridgway for State Senator in the second district.
[source: 8]
He appears to have married Amanda [unknown family name].
She was born in 1847/48, in Pennsylvania.
They seem to have had at least these children:
Harriet Bailey (b. 1863/64, PA)
Mary Bailey (b. 1865/66, PA)
George Bailey (b. 1866/67, PA)
Henry Bailey (b. September 1869, PA)
[source: 12]
In 1870, he may be the George Bailey living with Amanda (apparently his wife), and Harriet, Mary, George, and Henry (presumably their children).
He was living in the same building as Harriet (apparently his mother), and William, Charles, Joseph, Mary, and George (apparently siblings and a nephew).
He was a laborer, and owned $200 in personal property.
[source: 12]
In 1880, he wa apparently living at 1433 28th Street, Philadelphia, Pennsylvania.
He was living with his mother Harriet, siblings William, Harry, and Charles, and (probable children) George and Mary, along with a boarder.
He was a pavier [?] (or perhaps a whipmaker).
[sources: 13, 16]
On 2 February 1883, his mother, Harriet Bailey, died, at 2211 Virginia Street, ward 15, Philadelphia, Pennsylvania.
She died of chronic endocarditis with valvular disease.
She was 70 years old, and was born in England.
On 6 February 1883, she was buried, in Odd Fellows Cemetery, Philadelphia, Pennsylvania.
[sources: 14, 15]
In 1890, he was living at 1841 Callowhill Street, Philadelphia, Pennsylvania.
[source: 4]
On 11 April 1898, he applied successfully from Pennsylvania for a pension.
[sources: 6, 7]
He again applied for a pension on 4 March 1907.
[source: 7]
He died on 10 October 1927, in Glenolden [Delaware County], Pennsylvania.
He was a laborer.
He died of myocarditis, [and] endocarditist [?], with chronic interstitial nephritis [?] contributing.
On 14 October 1927, he was buried, in Mt Moriah Cemetery.
[sources: 7 (Folcroft), 9, 10]
Sources
1 Bates, Samuel Penniman. History of Pennsylvania volunteers, 1861-5. Harrisburg: B. Singerly, state printer, 1869-71. 5 volumes. 'Ninety-first regiment', volume 3, pages 186-233.
(In the roster)
(George Bayley)
2Civil War Veterans' Card File, available at the Pennsylvania State Archives, searched 1 August 2004
(George Bayley; rolls have 'George Baley')
41890 US census, veterans schedule, Pennsylvania, Philadelphia, Philadelphia, supervisor's district 1, enumeration district 276, page 1 (image 1562 on Ancestry), line 10
(George Bailey)
9 Pennsylvania death indices, 1927
("Baley, George W;--104908;Glen Olden;Oct.10." [Glenolden is in Delaware County])
10death certificate, Pennsylvania, Delaware County, 10 October 1927, file number 104908
(George W Baley)
111860 US census, Pennsylvania, Philadelphia, ward 24, precinct 6, microfilm series M653, film 1175, pages 813 = 9 handwritten to 814 = 10 handwritten (FamilySearch)
(Geo W Bailey)
121870 US census, Pennsylvania, Philadelphia, ward 15, district 45, microfilm series M593, film 1399, page 626 recto = 167 handwritten, post office 1509 Ogden St (FamilySearch)
(George Bailey)
131880 US census, Pennsylvania, Philadelphia, enumeration district 642, film 1188, pages 440C = 35 handwritten to 440D = 36 handwritten (FamilySearch)
(George Bailey)
14death notice, Philadelphia Inquirer 6 February 1883, page 5
(Harriet Baley)
15 [not transcribed.] [mother's] death certificate, Philadelphia, Pennsylvania, 2 February 1883, (FamilySearch)
(Harriet Bailey)
17index to compiled service records of volunteer Union soldiers who served in organizations from the state of Pennsylvania
(George W Bailey)
18index to compiled service records of volunteer Union soldiers who served in organizations from the state of Pennsylvania
(George W Baley)
Sources checked unsuccessfully
1850 US census
FamilySearch index (accessed 4 Feb 13)
four candidates:
(1) George W J Bailey (4, PA), with Joseph (27, PA), and Elizabeth (29, Ireland), along with James (2, PA), Edward E (0, PA) (PA, Philadelphia, Spring Garden, ward 1, page 317 verso = 636 handwritten = 68 handwritten, FamilySearch
(2) George Bailey (3, PA), with George (50, PA), Eliza (46, Mass), Emily J (22, PA), John (18, PA), Angeline (14, PA), Anna H (11, PA), Sarah (8, PA), and William H (5, PA) , PA, Philadelphia, Southwark, ward 5, page 357 [?] verso, FamilySearch)
(3) George Bayley (9, b. PA), with Daniel (33, b. NY, brickmaker), Mary Ann (28, b. PA), William (6, b. PA), Mary E (4, b. PA), Emma (3, b. PA), and Elmira (2, b. PA) (1850 US census, Pennsylvania, Philadelphia, Penn District, microfilm series M432, film 820, page 102 verso = 206 handwritten, FamilySearch, accessed December 2012)
(4) Geo Bailey (5, PA), with Jos (38, Ireland, stonecutter), Jane (35, Ireland), Jos (15, NY), Robt (13, NY), Mary (8, PA), Emil (4, PA), and Martha (1, PA) Philadelphia, Pennsylvania, Kensington, ward 2, microfilm series M432, film 806, page 65 verso = 120 handwritten (FamilySearch)
1860 US census
FamilySearch index (accessed 4 Feb 13)
five candidates:
(1) George Bailey (16, b. PA, app to book folder), with George (37, b.Ireland, watchman), Sarah (35, Ireland), William (10 [no occupation], b.PA), David (18, app to moulding [?], PA), Stewart (11, b. PA), and Robert (4, b. PA) (Pennsylvania, Philadelphia, 17th ward, eastern part, 16, b. PA, M653, film 1167, p.588 = 85 handwritten (FamilySearch)
(2) George Bailey (16, b. PA), with Joseph (49, Ireland, stonecutter), Jane (46, Ireland), Amanda M (8, PA), Martha (12, PA), William (6, PA), Joseph (25, NY, carpenter), Mary (18, PA, teacher), Emily (14, PA), and a servant (PA, Philadelphia, 17th ward, eastern part, M653, 1167, 607 = 104 handwritten (FamilySearch)
(3) George Bailey (19, b. PA), with Daniel (44, brickmaker, b. PA), Mary (36, b. PA), William (16, b. PA), Mary (15, b. PA), Emma (13, b. PA), Elmira (12, b. PA), James (6, b. PA), Kate (4, b. PA), and Harvey (3, b. PA) (1860 US census, Pennsylvania, Philadelphia, ward 19, microfilm series M653, film 1170, page 890 = 420 handwritten (FamilySearch))
(4) Geo W Bailey (17, PA, laborer), with Harriet (45, sempstress, England), Wm (25, mariner, PA), Henry (23, laborer, PA), Charles (19, laborer, PA), Joseph (15, PA), Isabella (14, PA), Mary (12, PA), et al. (Pennsylvania, Philadelphia, ward 24, precinct 6, M653, 1175, 814 = 10 handwritten (FamilySearch)
(5) George Bailley (13, PA), with George (50, Blacksmith, Phila), Eliza (56, Phila), Emerly (32, f, Phila), Sarah (18, Phila) (Pennsylvania, Philadelphia, ward 1, division 3 M653, 1151, 170 = 169 handwritten (FamilySearch)
1870 US census
Daniel and Mary Ann are at FamilySearch, with no George or William living with them
1880 US census
the Ancestry and FamilySearch indices found five plausible candidates (none in Delaware County Pennsylvania) (accessed 3 February 2013), summarized below in the 'note on identification'
I was not able to find the Amanda, Harriet, and Henry Bailey in the 1870 census entry transcribed below
1890 US census, veterans schedules
Ancestry index (accessed 3 February 2012): George Bailey living in Pennsylvania
(1) Pennsylvania, Philadelphia, e.d. 532, roll 80, page 2 (image 1751 of 2610): Harriet W Bailey widow of George Bailey, private F 175 PA (16 Oct 1862-7 Aug 1863), 3959 Warren St Philadelphia PA
(2) Pennsylvania, Philadelphia, e.d. 658, roll 80, page 1 (image 2145 of 2610): George S Bailey, private B 68 PA (14 Aug 1861 - 12 June 1865), 2324 N 29th St
(3) Pennsylvania, Montgomery County, Bridgeport, e.d. 186, page 1 (image 1 of 6): George F Bailey, corporal, E 124 PA Infantry (28 July 1862 - 16 May 1863), post office address Bridgeport PA
(4) Pennsylvania, Allegheny County, Pittsburgh, roll 88, e.d. 129, page 2 (image 325 of 413): George W Bailey, private 62 PA (no dated), post office address Pittsburg [sic] Allegheny PA
1900 US census
e.d. 687, Pennsylvania, Philadelphia, ward 28, page 114 = 14 B handwritten: at 3033 [sic] York, George A [?] Bailey, b. Jan 1840, PA, parents born PA, married 3 years, janitor school, with wife Emma M (b. Nov 1857, VA, 42 years old, married 3 years, no children), son [sic] James A Perkins (b. June 1884, VA, at school), and a lodger (FamilySearch)
e.d. 988, Pennsylvania, Philadelphia, ward 39, page 174 = 16 A handwritten: at 308 Mifflin Street, George A Bailey (b. Aug 1847, PA, father born PA, mother born Massachusetts, engraver), with wife Mary J (b. May 1848, PA, parents born Ireland, 6 children, 3 living) and son William (b. June 1884, PA, engraver assistant) (FamilySearch)
none in Delaware County (FamilySearch index, b. PA 1838/1848, accessed 3 February 2012)
1910 US census
e.d. 1012 George Baylie 62 b PA with Mary 61 b. PA, in household of Edgar R Dodd (37, b. PA), wife Lydie (32, b. PA), daughters Edna (11), Helen (3), and Mildred (1) Dodd (FamilySearch)
1920 US census
nothing in FamilySearch index (George Bailey, b. PA, 1838-1848)
1930 US census
FamilySearch index (accessed 22 March 2013)
Philadelphia death certificates
the FamilySearch index (accessed 4 Feb 13) found 3 candidates (George Bailey, born PA 1838/1848, died 1860-1930)
(1) George Bailey, born PA, 62 years old, widowed, laborer, residence Shawmut [Elk County] PA, died 30 Dec 1907, at Elk County Home, of catarrh of Stomach, buried 7 Jan 1908, Lancaster PA (FamilySearch, Philadelphia PA death certificates, 30 December 1907, #541, George Bailey)
(2) George S Bailey, born Philadelphia, 61 years old, married, janitor, died 4 September 1901, Philadelphia, 28th ward, 3000 W York St, of gastroenteritis, buried 8 September 1901 at Mount Peace, Philadelphia (FamilySearch, Philadelphia PA death certificates, 4 September 1901, #6046 [?], George S Bailey)
(2a) "BAILEY--On September 4, 1901, George Bailey. Late residence, 3013 West York street. Due notice of the funeral will be given." [death notice, Philadelphia Inquirer 5 September 1901, page 15, George Bailey)
(3) George Bailey, 33, born Phila, [marital status and occupation not listed], died 20 July 1881, Philadelphia Hospital, Philadelphia, ward 27, of asthenia, buried 21 July Mount Moriah (FamilySearch, Philadelphia PA death register, 20 July 1881, volume B, page 16, George Bailey; and death certificateFamilySearch)
(3a) [no death notice in 20 or 21 July 1881 Philadelphia Inquirer]
(3b) [it's tempting to assume this is the George Bailey who in 1880 was living in Blockley Alms House]
Pennsylvania veterans' burial records
Ancestry index (accessed 7 Apr 12)
RootsWeb WorldConnect
accessed 3 February 2013 (searched for George Bailey (metaphone) born 1844 +/- 1 father Daniel; and for George Bailey (metaphone) born 1844 +/- 5 died 1927)
Find a grave
checked for George Bailey/Baley/Bayley died 1927 buried Pennsylvania; also checked Glenolden Cemetery (accessed 3 February 2013)
GenealogyBank
searched for George Bailey/Baley in October 1927 in Pennsylvania (accessed 17 March 2013)
searched for Amanda Bailey/Bayley 1870-1880 in Philadelphia Pennsylvania (accessed 22 March 2013)
applications for headstones for military veterans 1925-1941
I have so far identified five plausible candidates, based on the 1880 census.
(See the summaries of the census records above for possible additional candidates.)
Of these, the first fits best, given the parents' names on the death certificate transcribed below.
George Bailey, born 1843/44, PA to William and Harriet (b. ca 1814, England) Bailey
[see the census records transcribed below]
George S Bailey (born ca 1840/41, PA, brick burner in 1880), married to Catherine (b. ca 1844, PA), children Joshua (b. ca 1866, PA), and Sarah (b. ca 1876, PA)
1880 US census, Pennsylvania, Philadelphia, enumeration district 602, microfilm series T9, film 1187, page 496 = 31 A handwritten: at 2303 Caroline Street, George S Bailey (39, born PA, brick burner) with wife Catherini [sic] Bailey (36 b. PA, son Joshua (14, b. PA, laborer) and daughter Sarah (4 born PA) (FamilySearch)
1870 US census, microfilm series M593 film 1407 page 506 verso = 162 handwritten, Geo S 29 brickmaker Catharine 27 Joshua 4 all born PA FamilySearch
George Bailey, b. 1842/43, Philadelphia
1880 US census, Pennsylvania, Philadelphia, Blockley Alms House, enumeration district 569, film 1186, page 10 = 3 C handwritten: George Bailey (37, single, born Philadelphia, parents born PA, no occupation, blind, deaf and dumb) (FamilySearch)
George Bailey (b. 1844/45, PA, clerk in 1880), married to Elizabeth (b. ca 1850, PA)
1880 US census Pennsylvania, Philadelphia, ward 7, precinct 3, enumeration district 116, film 1170, page 34 = 10 B handwritten: at 924 Pine Street, George Bailey (35, b PA, parents born PA, clerk) with wife Elizabeth (30, b. PA) (FamilySearch)
George Bailey, b. 1844/45, PA, married Annie (b. ca 1852, PA), with daughter Jane (b. ca 1879, PA)
1880 US census, Pennsylvania, Philadelphia, ward 16, enumeration district 293, film 1176, pages 57 = 1 A to 57 = 1 B handwritten: at 1107 [last digit hard to read] Howard Street, George Bailey (35, b. PA [sic], parents born Ireland, policeman) with wife Annie (28, b, PA, parents born PA), and daughter Jane (1, b. PA, father born Ireland [sic]) (FamilySearch)
note also George Bailey, b. 1839/40, Louisiana
1880 US census, Pennsylvania, Philadelphia, enumeration district 583, microfilm series T9, film 1186, page 218 = 4 D handwritten: at 3612 Sansom Street, George Bailey (40, b. Louisiana, parents born LA, machinist), with wife Maria M (30, b. Ireland, parents born Ireland), son William (11, b.PA), and daughter Lizzie (6, b. PA) (FamilySearch)
Display
George W Bayley in the 91st PA gedcom on RootsWeb WorldConnect
[1860 US census, Pennsylvania, Philadelphia, ward 24, precinct 6, microfilm series M653, film 1175, pages 813 = 9 handwritten to 814 = 10 handwritten (FamilySearch)]
[identification is speculative; see the note on identification above]
[1870 US census, Pennsylvania, Philadelphia, ward 15, district 45, microfilm series M593, film 1399, page 626 recto = 167 handwritten, post office 1509 Ogden St (FamilySearch)]
[identification is speculative; see the note on identification above]
line
12
13
14
15
16
17
18
19
20
21
22
23
Dwelling-house number
1206
Family number
1360
1361
Name
Bailey Harriet
- William
- Charles
- Joseph
- Mary
- George
Bailey George
- Amanda
- Harriet
- Mary
- George
- Henry
Age
56
35
28
25
22
4
26
22
6
4
3
8/12
Sex
F
M
M
M
F
M
M
F
F
F
M
M
Color
W
W
W
W
W
W
W
W
W
W
W
W
Occupation
Keeping House
Brick Mason
Brick Mason
Laborer
Laborer
Keeping House
Real estate value
Personal estate value
200
200
Birthplace
England
Penna
Penna
Penna
Penna
Penna
Penna
Penna
Penna
Penna
Penna
Penna
Father foreign born
1
1
1
1
1
1
1
Mother foreign born
1
1
1
1
1
1
1
Birth month if born within year
Sept
Marriage month if married within year
Attended school past year
Can't read
Can't write
Deaf, dumb, blind, etc.
Male US citizen at least 21 years old
1
1
1
1
Male US citizen at least 21 years old who can't vote ...
[1880 US census, Pennsylvania, Philadelphia, enumeration district 642, film 1188, pages 440C = 35 handwritten to 440D = 36 handwritten (FamilySearch)]
[identification is speculative; see the note on identification above]
[1890 US census, veterans schedule, Pennsylvania, Philadelphia, Philadelphia, supervisor's district 1, enumeration district 276, page 1 (image 1562 on Ancestry), line 10]
[identification is confirmed by reference to his service in the 91st]
[line] 10
[house] 97
[family] 99
[name] George Bailey
[rank] Private
[company] D
[unit] 91 Pa Inf
[enlistment date] Jan 1 1864
[discharge date] July 10 1865
[length of service] 1 year, 5 months, 19 days
[post office address] 1841 " " [sc. Callowhill St]
[disability incurred] [blank]
[remarks] [blank]
[Ellen Harvey, widow of Harvey, was also living there]
[index to compiled service records of volunteer Union soldiers who served in organizations from the state of Pennsylvania]
[transcribed 11 Mar 2014, from Fold3]
Bailey George W.
Co. D., 91 Pennsylania Inf.
Pvt | Pvt
REFERENCE CARD.
Original filed under
Baley George
George W.
GENERAL INDEX CARD.
[card 2, transcribed 15 March 2014]
Baley George W.
George
Co. D., 91 Pennsylvania Inf.
Pvt | Pvt
See also [blank]
[Philadelphia city directories; transcribed from Fold3]
1871 Gopsill's Philadelphia directory (transcribed all ten 'George Bailey', no 'George Baley', no 'George Bayley', two 'George Baylie' entries]
[p.170] "Bailey George, h 308 Jarvis"
[p.170] "Bailey George, bartender, 1019 S 9th"
[p.170] "Bailey George, carpenter, h 51 State, W P"
[p.170] "Bailey George, ironmaster, h 1625 Walnut"
[p.170] "Bailey George, laborer, h r 210 Duponceau"
[p.170] "Bailey George, laborer, h Penna av n Columbia bridge"
[p.170] "Bailey George, moulder, h 26 Laurel"
[p.170] "Bailey George, wheelwright, h 135 Sloan, W P"
[p.170] "Bailey George W., laborer, h 910 Buttonwood"
[p.170] "Bailey George W., physician, h 413 Pine"
[p.196] "Baylie George, gasfitter, h 1337 Wheat"
[p.196] "Baylie George A., provisions, 934 S 4th, h 1337 Wheat"
[did not find Harriet widow of William]
1879 Philadelphia directory (p.127) (all 8 'George Bailey' entries and 1 'George Baylie' entry transcribed; no 'George Baley' [or Harriet Baley, or any Baley at 28th st] 'George Bayley' or 'George Bayly')
"Bailey George, butcher, 2129 Oxford"
"Bailey George, clerk, 231 Dock, h 924 Pine"
"Bailey George, laborer, h 120 Chestnut pl"
"Bailey George, police, h 6 Laurel"
"Bailey George, rigger, h 1314 Clarion"
"Bailey George W., bookkeeper, h 1230 Mosely"
"Bailey George W., butcher, Southwestern mkt, h 2129 Oxford"
[p.155] "Baylie George A., nurse, h 216 Siegel"
1880 Gopsill's Philadelphia directory (p.129) (all 6 'George Bailey' entries, and the one 'George Baley' entry [and the other 'Baley' entries at the same address] and the one 'George Baylie' entry transcribed; no 'George Bayley' or 'George Bayly' entries):
"Bailey George, bartender, h 1401 Filbert"
"Bailey George, carpenter, h 627 Curlew"
"Bailey George, machinist, h 120 Chestnut pl"
"Bailey George, police, h 6 Laurel"
"Bailey George W., bookkeeper, h 1230 Mosely"
"Bailey George W., butcher, N 19th st mkt, h 2133 Ridge av"
[p.136] "Baley George W. whip mkr, h 1433 N 28th"
[p.136] "Baley Harriet, wid William h 1433 N 28th"
[p.136] "Baley Henry, paver, h 1433 N 28th"
[p.136] "Baley John, bricklayer, h 1433 N 28th"
[p.136] "Baley William, laborer, h 1433 N 28th"
[p.159] "Baylie George A., plumber, h 606 McKean"
1881 Gopsill's Philadelphia directory (p.126) (all 6 'George Bailey' entries transcribed; no 'George Baley' or 'George Bayley' entries):
"Bailey George, clerk, h 1317 Parrish" [perhaps this is entry #4 in the 1880 census abstract above]
"Bailey George, laborer, h 120 Chestnut pl"
"Bailey George F., carbuilder, h 627 Curlew"
"Bailey George W. (Bailey & Corney), h 2133 Ridge av" [p.125: 'BAILEY & CORNEY (George W Bailey & Francis H. Corney), provisions, 1634 Market']
"Bailey George W., bookkeeper, h 707 Morris"
"Bailey George W., police, h 6 Laurel" [this is presumably entry #5 in the 1880 census abstract above]
[p.154] "Baylie George A., clerk, h 606 McKean" [also "Baylie Eliza, wid George A., h 606 McKean"]
[death notice, Harriet Baley, Philadelphia Inquirer 6 February 1883, page 5]
[transcribed from GenealogyBank]
BALEY.--On the 2d instant, HARRIET, wife of the late William Baley, Sr, in the seventieth year of her age.
The relatives and friends of the family are respectfully invited to attend the funeral, from her late residence, No 2211 Virginia street, this afternoon, at 2 o'clock. To proceed to Odd Fellows' Cemetery.
[death certificate, Pennsylvania, Delaware County, 10 October 1927, file number 104908, George W Baley]
[obtained from PA Department of Health, 16 March 2013, ordered 6 October 2012]
BUREAU OF VITAL STATISTICS
File No. 104908
Registered No. 99
Registration District No. 468
Primary Registration District No. 99
County of Delaware
Borough of Glenolden
(No. 77, Ridgeway Av)
2. FULL NAME George W. Baley
PERSONAL AND STATISTICAL PARTICULARS
3. SEX Male
4. COLOR OR RACE White
5. Widowed
5a. If married, widowed, or divorced HUSBAND of (or) WIFE of [blank]
6. DATE OF BIRTH Feb 2 1844
7. AGE 83 Years 8 Months 8 Days
8. OCCUPATION OF DECEASED
(a) Trade, profession, or particular kind of work Laborer
9. BIRTHPLACE Pa
10. NAME OF FATHER William Baley
11. BIRTHPLACE OF FATHER Pa
12. MAIDEN NAME OF MOTHER Harriet [illegible; looks like 'Neymid' [?] or 'Dynid' [?]]
13. BIRTHPLACE OF MOTHER Pa
14. Informant Mrs Samuel Conard [sic]
(Address) 77 Ridgeway Ave Glenolden Pa
15. Filed Oct 11 [??], 1917
Samuel Wilcox [?] Registrar
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH Oct 10 1927
17. I HEREBY CERTIFY, That I attended deceased from June [?] 15, 1927, to Oct 10, 1927
that I last saw him alive on Oct 10, 1927
and that death occurred, on the dated stated above, at 6.35 [?] PM.
The CAUSE OF DEATH was as follows:
Myocarditis Endocarditis [??] (duration) [blank]
CONTRIBUTORY (secondary) Chronic Interstitial nephritis [??]
18. Where was disease contracted if not at place of death? [blank]
Did an operation precede death? [blank]
Was there an autopsy? [blank]
What test confirmed diagnosis? [blank]
(Signed) John Hansen [??] M.D.
Oct 12 1927 Address Glenolden
19. PLACE OF BURIAL, CREMATION OR REMOVAL Mt Moriah Cem.
DATE OF BURIAL Oct 14 1927
20. UNDERTAKER Mrs A J Trimly [??] [illegible] Thos. B. Trimly [??]
ADDRESS Media Pa