91st PA: Charles Beaver

Charles Beaver

Before the war

He was born on 25 November 1844, in Pennsylvania. [sources: date: 11, 16 (Jan 1847); 4 (18 in 1861), 7 (68 in 1916), 9 (76 at death in 1920), 12 (50 in 1895), 13 (29 in 1870), 15 (35 in 1880), 17 (62 in 1910), 18 (75 in 1920), 19 (1844). place: 11, 13, 15, 16, 17, 18]

During the war

He enlisted and was mustered into service on 30 September 1861. He enlisted at Philadelphia, Pennsylvania. He was mustered in as a private, at Philadelphia, Pennsylvania. He was a private in company D. [sources: 1, 4, 5, 7, 8 (1 Sep 61), 25, 26]

He was wounded on 13 December 1862 at Fredericksburg, Virginia. [sources: 1, 4]

He was discharged on 4 May 1863, at Washington DC, because of his wounds. The regiment reported his discharge on 15 May 1863. He was a private, in company D. [sources: 1 (15 May), 2, 3 (15 May), 4 (15 May), 5 (15 May), 7, 8, 25, 26]

After the war

On 15 May 1863, he applied successfully from Pennsylvania for a pension. [sources: 6, 8]

He married Louisa J Davidson. She was born in 1842/43, in Pennsylvania. They apparently had at least one child:

[sources: 13, 15]

In 1870, he was living in ward 7, Harrisburg, Dauphin County, Pennsylvania. He was living with Louisa (apparently his wife). He worked in grocery. [source: 13]

In 1880, he was living at 824 North Third Street, Harrisburg, Dauphin County, Pennsylvania. He was living with his wife Louisa, daughter Minnie, and a servant. He was a huckster. [source: 15]

In 1890, he was living on 3rd Street, in Harrisburg, Dauphin County, Pennsylvania. [source: 5]

In 1894, Susan Wilson, guardian of the children of John N Hawks alias James Clark (D), contacted him for help with her pension application on their behalf. He was apparently living at 805 N 3rd Street, Harrisburg, Dauphin County, Pennsylvania. He did not give her an affidavit, but did write:

I knew James Clark, Sargeant [sic] of Co D 91st Pa V[.] I believe it is the same John N Hawks, that enlisted in the US Navy for he had a Brother in Co D 91. by the name of Hakwes a younger man [sc. Samuel Hawks.] I often wondered how one was named Clark and the other Hawks. some one said that they were step brothers, but this explains it[.] he enlisted in 91st PV. under an assumed name

[source: 24]

On 22 March 1895, his wife, Louisa J Davidson, died, at her residence, 805 North Third Street, Harrisburg, Dauphin County, Pennsylvania. [source: 14]

On 11 December 1895, he married Martha E Gitt, at Harrisburg, Dauphin County, Pennsylvania. She was born in April 1856. They were married by B F Dimmick, minister. They had both been married before. She had been married to Henry W Gitt; they had two children, Hannah (born Aug 1877, PA, married Alpha Foltz) and Margaret Elizabeth (born Sept 1878, PA, married Howard Burton Masser, born 1873/74, on 6 July 1910, in Harrisburg, Dauphin, PA). He was a trucker, and she ran a boarding house. [sources: 12, 16 (3 yrs in 1900), 17 (14 yrs in 1910), 20 (1853), 22, 23]

In 1900, he was living at 805 North 3rd Street, ward 4, Harrisburg, Dauphin County, Pennsylvania. He was living with his wife Martha, step daughter Hannah W Hill and her two children, and stepdaughter Margaret E Gitt. He was a provisions merchant. [source: 16]

He again applied for a pension on 30 November 1907. [source: 8]

In 1910, he was living at 805 Third Street, ward 4, Harrisburg, Dauphin County, Pennsylvania. He was living with his wife Martha E, his stepdaughters Hannah Falts and Margret E Gitt, his stepgrandchildren Russell and Helen Hill, and his grandson Charles Folz. He was a wholesale dealer in produce. [source: 17]

In 1916, he was receiving a pension of $21.50 per month. This rate began on 25 November 1915. He had a left groin wound, rheumatism, heart disease, and indigestion. He had no means, no property, and no income except for his pension. The House Committee on pensions recommended his pension be increased to $30 per month. [source: 7]

In 1920, he was living at 805 North Third Street, ward 4, Harrisburg, Dauphin County, Pennsylvania. He was living with his wife Martha, his stepdaughter Margaret Masser, and his stepgrandchildren Helen and Russell Hill. He was not working. [source: 18]

He died on 12 December 1920, at 811 Green Street, ward 4, Harrisburg, Dauphin County, Pennsylvaniae. On 15 December 1920, he was buried in Harrisburg Cemetery, Harrisburg, Dauphin County, Pennsylvania. He was a member of Grand Army of the Republic post 58. [sources: 8, 9, 10, 11, 19]

On 15 December 1920, his widow, Martha E Beaver, applied successfully from Pennsylvania for a pension. He was a fruit dealer. He died of chronic myocarditis, with bronchial asthma contributing. [sources: 6, 8]

On 19 April 1922, his widow, Martha E Beaver, died, in Harriburg, Dauphin County, Pennsylvania. She was buried in Harrisburg Cemetery, Harrisburg, Dauphin County, Pennsylvania. [sources: 20, 21]

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) (Charles Beaver)

2 consolidated morning report, 91st PA, 15 May 63 (Charles Beaver)

3 company D, register of men discharged, entry 18 (Charles Beavers)

4 Civil War Veterans' Card File, available at the Pennsylvania State Archives, searched 8 August 2004 (Charles Beaver)

5 1890 US census, veterans' schedule, Pennsylvania, Dauphin County, Harrisburg, supervisor's district 4, enumeration district 41, page [2] (image 31 of 148 on Ancestry) (Charles Beaver)

6 pension index, by name (Charles Beaver)

7 'Pensions and increase of pensions to certain soldiers and sailors of the Civil War and certain widows and dependent children of soldiers and sailors of said war. April 11, 1916.' (House Report 523, 64th congression 1st session, serial set volume 6908, session volume 8) (Charles Beavers)

8 pension index, by regiment, 91st PA Infantry, company D (Charles Beavers)

9 death notice, Patriot, 13 December 1920, page 4 (Charles Beaver)

10 Pennsylvania death indices, 1920 ("B160 Charles Beaver Hbg 125045 12/12")

11 death certificate, Pennsylvania, 12 December 1920, file number 125045 (Charles Beaver)

12 Pennsylvania county marriages 1885-1950, Dauphin County, 1895, p.397 (Charles Beaver)

13 1870 US census, Pennsylvania, Dauphin County, Harrisburg, ward 7, microfilm series M593, film 1334, page 314 recto = 19 handwritten (FamilySearch) (Charles Beaver)

14 death notice, Patriot [Harrisburg PA] Tuesday 26 March 1895, page copy of 5 (Louisa J Davidson wife of Charles Beaver)

15 1880 US census, Pennsylvania, Dauphin County, Harrisburg, microfilm series T9, film 1123, page 324 = 177 C handwritten (FamilySearch) (Charles Beaver)

16 1900 US census, Pennsylvania, Dauphin County, Harrisburg, ward 4, enumeration district 52, microfilm series T623, film 1402, page 262 = 4 A handwritten (FamilySearch) (Charles Beaver)

17 1910 US census, Pennsylvania, Dauphin County, Harrisburg, ward 4, microfilm series T624, film 1336, enumeration district 62, page 152 = 5 B handwritten (FamilySearch) (Charles Beaver)

18 1920 US census, Pennsylvania, Dauphin County, Harrisburg, ward 4, enumeration district 70, microfilm series T625, film 1559, page 31 = 10 B handwritten (FamilySearch) (Charles Beaver)

19 Find a grave, memorial 36595930, created by Glenn Koons, added 1 May 2009, accessed 18 May 2013 [identity is confirmed by reference on the pictured stone to his service in the 91st PA] (Charles Beaver)

20 Find a grave, memorial 36595913, created by Glenn Koons, added 1 May 2009, accessed 18 May 2013 (Martha Beaver)

21 Pennsylvania death indices, 1922 ("B160 Martha E Beaver 40988 Hbg 4/19")

22 [not transcribed] marriage record, Margaret Elizabeth Gitt to Howard Burton Masser (available on FamilySearch, accessed 20 May 2013)

23 [not transcribed] marriage record, Charles Beaver Foltz to Marjorie George (available on FamilySearch, accessed 20 May 2013)

24 Navy pension certificate file, National Archives and Records Administration, record group 15, microfilm series M1469, certificate 13952, John N Hawks [see especially page 23] (Charles Beaver)

25 index to compiled service records of volunteer Union soldiers who served in organizations from the state of Pennsylvania (Charles Beaver)

26 index to compiled service records of volunteer Union soldiers who served in organizations from the state of Pennsylvania (Charles Beavers)

Sources checked unsuccessfully

RootsWeb WorldConnect
searched Charles Beaver (exact) d. 1920 spouse Martha; Charles Beaver exact spouse Martha; Charles Beaver exact b. PA 1844 +/- 2; Charles Beaver exact spouse Louisa (accessed 18 May 2013)
1850 US census
FamilySearch index had nothing for Charles Beaver born PA 1843-1845 resident PA (accessed 19 May 2013)
Ancestry index had a Charles Beaver 5 in ward 6, Spring Garden, Philadelphia, Pennsylvania (accessed 19 May 2013)
There is a Charles Beaver in Union, Union County, PA, with Mathias (43) and Solomy (40) Beaver et al., but he is only 3 years old FamilySearch
1860 US census
FamilySearch index had nothing for Charles Beaver born PA 1843-1845 resident PA (accessed 19 May 2013)
Ancestry index (accessed 19 May 2013)
1930 US census
FamilySearch index (accessed 19 May 2013)
Pennsylvania veterans burial cards 1777-1999
Ancestry index (accessed 19 May 2013)
applications for headstones for military veterans, 1925-1941
FamilySearch index (accessed 19 May 2013)

Display


Charles Beaver in the 91st PA gedcom on RootsWeb WorldConnect

Charles Beaver in the 91st PA database

1870 census

[1870 US census, Pennsylvania, Dauphin County, Harrisburg, ward 7, microfilm series M593, film 1334, page 314 recto = 19 handwritten (FamilySearch)]
[I did not transcribe the other family at this residence, headed by David Davidson (52, police officer) and Abeckle Davidson (49)]
[identification is likely; see the note on the 1880 census entry below]
[note that the Ancestry index had no Louisa Beaver born 1841-1845 living in PA in any 1900 censuses (accessed 19 May 2013)]
[note also that although he was married only once according to the 1910 census, his marriage license application claims he was married before his marriage to Martha Gitt]
line2526
Dwelling-house number[151] 
Family number[154] 
NameBeaver Charles- Louisa
Age2927
SexMF
ColorWW
OccupationGroceryAt Home
Real estate value  
Personal estate value  
Birthplace- [sc. Penna]-
Father foreign born  
Mother foreign born  
Birth month if born within year  
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 old1 
Male US citizen at least 21 years old who can't vote ...  

1880 census

[1880 US census, Pennsylvania, Dauphin County, Harrisburg, microfilm series T9, film 1123, page 324 = 177 C handwritten (FamilySearch)]
[identification is likely, since (1) the address in Louisa's death notice matches the address in the 1900 census]
line24252627
street nameNorth Third Street
house number824   
dwelling visit #70   
family visit #73   
nameBeaver Charles- Louisa- MinnieDuncan Rebecca
colorWWWW
sexMFFF
age35351059
month born if born in year    
relationship WifeDaughterServant
single  11
married11  
widowed/divorced    
married during year    
occupationHucksterKeeping HouseAt SchoolServant
months unemployed    
currently ill?    
blind    
deaf/dumb    
idiotic    
insane    
disabled    
school this year  1 
can't read   1
can't write   1
birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
father's birthplaceIrelandPennaPennaPenna
mother's birthplacePaPaPaPa

1890 census, veterans schedule

[1890 US census, veterans' schedule, Pennsylvania, Dauphin County, Harrisburg, supervisor's district 4, enumeration district 41, page [2] (image 31 of 148 on Ancestry) (FamilySearch)]
{identity is confirmed by reference to his service in the 91st]

[line] 17
[house] 3rd st
[family] [blank]
[name] Charles Beaver
[rank] Pri
[company] D
[unit] 91 Pa Vol
[enlistment date] 30 Sep 1861
[discharge date] 15 May 1863
[length of service] [blank]
[post office address] 3rd st Harrisburg
[disability incurred] [blank]
[remarks] [blank]

1900 census

[1900 US census, Pennsylvania, Dauphin County, Harrisburg, ward 4, enumeration district 52, microfilm series T623, film 1402, page 262 = 4 A handwritten (FamilySearch)]
[identification is likely, since (1) his wife's name matches the widow's name in the pension index by name (entry 6 above)]
line49501234
streetN. 3rd St.    
house number805     
dwelling number82     
family number84     
nameBeaver Charles- Martha EHill Hannah W- Russel E- Helen GGitt Margaret E
relationshipHeadWifeS-daughterG-SonG-daughterS-daughter
colorWWWWWW
sexMFFMFF
birth dateJan 1847April 1856Aug 1877May 1897Sept 1899Sept 1878
age53442238/1221
married?MMMSSS
# years married334   
mother of how many children? 32   
# of children living 22   
birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
father's birthplaceIrelandPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
mother's birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
immigration year      
# years in USA      
naturalized citizen?      
occupationMerchant - Provisions     
# months not employed0     
# months in school      
can readyesyesyes  yes
can writeyesyesyes  yes
speaks Englishyesyesyes  yes
owned/rentedO     
free or mortgagedM     
farm/houseH     
# of farm schedule      

1910 census

[1910 US census, Pennsylvania, Dauphin County, Harrisburg, ward 4, microfilm series T624, film 1336, enumeration district 62, page 152 = 5 B handwritten (FamilySearch)]
[identification is likely, since (1) his wife's name matches the widow's name in the pension index by name (entry 6 above)]
line59606162636465
streetThird St
house nr805      
dwelling nr125      
family nr125      
nameBeaver Charles- Martha EFaltz Hannah WGitt Margret EHill Russell E- Helen GFolz Charls [sic] B
relationshipHeadWifeDaughterS DaughterLodgerLodgerGrandson
sexMFFFMFM
colorWWWWWWW
age62523129121022
marital statusM1M2M2SSSS
#years present marriage141412    
mother of # children 34    
mother of # living children 23    
birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
father's birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
mother's birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
immigrated       
naturalized/alien       
speaks EnglishEnglishEnglishEnglishEnglishEnglishEnglishEnglish
occupationWholesale dealerNoneNoneNoneNoneNoneClerk
nature of industry etc.Produc [sic]     Dry Goods store
employer etc.Emp     w
out of work 15 Apr 1910?      No
# weeks out of work 1909      0
can readyesyesyesyesyesyesyes
can writeyesyesyesyesyesyesyes
school since 1 Sep 09    yesyes 
owned/rentedO      
owned free or mortagagedM      
farm/houseH      
nr on farm schedule       
civil war vet       
blind       
deaf & dumb       

1920 census

[1920 US census, Pennsylvania, Dauphin County, Harrisburg, ward 4, enumeration district 70, microfilm series T625, film 1559, page 31 = 10 B handwritten (FamilySearch)]
[identification is likely, since (1) his wife's name matches the widow's name in the pension index by name (entry 6 above)]
line7778798081
streetNorth Third Street
house number805    
dwelling visit number244    
family visit number296    
nameBeaver Charles- MarthaMasser MargaretHill Helen [?]- Russell
relationshipHeadWifeStep-daughterStep-granddaughterStep-grand-son
own/rentR    
free/mortgaged (if owned)     
sexMFFFM
raceWWWWW
age at last birthday7560342021
marital statusMMWSS
year of immigration     
naturalized/alien     
year of naturalization     
attended school since Sept 1919   No [?]No [?]
can readYesYesYesYesYes
can writeYesYesYesYesYes
birth placePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
native language     
father's birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
father's native language     
mother's birthplacePennsylvaniaPennsylvaniaPennsylvaniaPennsylvaniaPennsylvania
mother's native language     
can speak EnglishYesYesYesYesYes
occupationNoneNoneNoneNoneNone
industry, business     
employment status     
number of farm schedule     

index to compiled service records

[index to compiled service records of volunteer Union soldiers who served in organizations from the state of Pennsylvania]
[transcribed 10 Mar 2014, from Fold3]


Beaver Charles
Co. D, 91 Pennsylvana Inf.
Pvt | Pvt
REFERENCE CARD.
Original filed under
Beavers Charles

GENERAL INDEX CARD.


[card 2, transcribed 16 March 2014]

Beavers Charles
Co. D, 91 Pennsylvania Inf.
Pvt | Pvt
See also [blank]

GENERAL INDEX CARD.

marriage record

[Pennsylvania county marriages 1885-1950, Dauphin County, 1895, p.397]
[transcribed from FamilySearch, 19 May 2013]

APPLICATION FOR MARRIAGE LICENSE
No. 397
1. Full name of the man, Charles Beaver
2. Full name of the woman, Martha E. Gitt
3. Relationship of the parties, either by blood or marriage, No
4. Age of the man, 50
5. Age of the woman, 39
6. Residence of the man, Hbg
7. Residence of the woman, Hbg
8. Parents' names--man, --
9. Parents' names--woman, --
10. Guardian's name--man, --
11. Guardian's name--woman,--
12. Have you been married before--man, Yes
13. Have you been married before--woman, Yes
14. Date of divorce or death--man, Wife Dec'd about 1 year
15. Date of divorce or death--woman, Husband " 4 years
16. Color of parties, White
17. Occupation of man, Trucker
18. Occupation of woman, Boarding House
19. Consent of parents or guardian of man, --
20. Consent of parents or guardian of woman, --

Dauphin County, ss:

Personally appeared before me, Clk OC of said County of Dauphin, Charles Beaver and -- who, being duly qualified according to law, did depose and say that the statements above set forth are correct and true, to the best of their knowledge and belief.


Charles Beaver
Sworn and subscribed before me, this 11 day of Dec A.D. 1895
H L Hensly [?] Clk OC

No. 397 MARRIAGE LICENSE.
STATE OF PENNSYLVANIA, County of Dauphin, SS:
To any Minister of the Gospel, Justice of the Peace, or other officers or persons authorized by law to solemnize marriage:

Legal evidence having been furnished to me in accordance with the Act of Assembly, approved the twenty-third day of June, one thousand eight hundred and eighty-five, you are hereby authorized to join together in the holy state of Matrimony, according to the rites and ceremonies of your church, society or religious denomination and the laws of the Commonwealth of Pennsylvania,

Charles Beaver and Martha E. Gitt
GIVEN UNDER MY HAND AND THE SEAL OF THE ORPHANS' COURT of said County of Dauphin, at Harrisburg, this 11 day of Dec A.D. 1895
{SEAL}
H L Hensley
Clerk O.C.

No. 397 DUPLICATE CERTIFICATE.
I, B F Dimmick hereby certify, that on the 11 day of Dec one thousand eight hundred and ninety 5 at Harrisburg Pa Charles Beaver and Martha E. Gitt were by me united in marriage, in accordance with license issued by the Clerk of the Orphans' Court of Dauphin County, Pennsylvania, numbered 397
B F Dimmick
Minister of the Gospel

House Report 523

'Pensions and increase of pensions to certain soldiers and sailors of the Civil War and certain widows and dependent children of soldiers and sailors of said war. April 11, 1916.' (House Report 523, 64th congression 1st session, serial set volume 6908, session volume 8)
[This is repeated in 'Pensions and increase of pensions for certain soldiers and sailors of the Civil War, and certain widows and dependent children of soldiers and sailors of said war. April 29, 1916' (Senate report 407, 64th congress, 1st session, Serial set volume 6901, session volume B), page 8]

H. R. 1786. Charles Beavers, aged 68 years, late a private in Company D, Ninety-first Regiment Pennsylvania Infantry, from September 30, 1861, to May 4, 1863 (length of service, 1 year 7 months 5 days), is now pensioned under certificate No. 17976 at the rate of $21.50 per month.

He was formerly pensioned under the general law at $4 for gunshot wound of left leg; increased to $8 under act of June 27, 1890, for the gunshot wound and rheumatism, disease of heart, and indigestion; increased to $12 under act of February 6, 1907; to $16.50 and to $21.50, the latter rate commencing November 25, 1915.

Medical testimony filed in support of the bill indicates the claimant is three-fourths disabled for manual labor by wound of left groin, rheumatism, disease of heart, and indigestion, supplemented by other testimony indicating that he has no means nor property, and is without income except his pension, which it is recommended be increased to $30 per month.

death notice, Louisa

[death notice, Patriot [Harrisburg PA] Tuesday 26 March 1895, page copy of 5]
[transcribed from GenealogyBank, 19 May 2013]

BEAVER--On Friday evening at six o'clock, at her residence, 805 North Third street, Mrs. Louisa J. Davidson, wife of Charles Beaver.

Funeral on Tuesday afternoon at two o'clock from her late residence. Relatives and friends are invited.

death notice

[death notice, Patriot, 13 December 1920, page 4, Charles Beaver]
[transcribed from GenealogyBank]

CHARLES BEAVER

Charles Beaver, 811 Green street, 76 years old, died yesterday after a long illness. He was a member of Post 58, G.A.R., and is survived by his wife, Mrs. Martha Beaver, one daughter, Mrs. Howard Masser, of this city, and two grandchildren Russell E. and Helen G. Hill.

The funeral will be held Wednesday afternoon at 2.30 o'clock from the residence, with burial in Harrisburg Cemetery. The Rev. Dr. Bagnell, of Grace Methodist Church, will conduct the service.

death certificate

[death certificate, Pennsylvania, 12 December 1920, file number 125045, Charles Beaver]
[transcribed 19 May 2013, received from Pennsylvania Division of Vital Records]

CERTIFICATE OF DEATH
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH
BUREAU OF VITAL STATISTICS
File No 125045
Registered No. 1405
PLACE OF DEATH
County of Dauphin
City of Harrisburg
(No. 811 Green St., 4 Ward.)
Registration District No. 461 [?]
Primary Registration District No. 38
2. FULL NAME Charles Beaver

PERSONAL AND STATISTICAL PARTICULARS
3. SEX Male
4. COLOR OR RACE White
5. Married
6. DATE OF BIRTH Nov 25 1844
7. AGE 76 yrs. [blank] mos. [blank] ds.
8. OCCUPATION
(a) Trade, profession, or particular kind of work Fruit dealer
(b) General nature of industry, business, or establishment in which employed (or employer) [blank]
9. BIRTHPLACE Penna
10. NAME OF FATHER -- Beaver
11. BIRTHPLACE OF FATHER Don't know
12. MAIDEN NAME OF MOTHER " "
13. BIRTHPLACE OF MOTHER " "
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) Mrs Martha Beaver
(Address) 811 Green St.
15. Filed Dec 14 1920 W D Black Local Registrar.

MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH Decr 12 1920
17. I HEREBY CERTIFY, That I atttended deceased from Oct 15 1920, to Dec. 12 1920, that I last saw him alive on Dec 12 1920, and that death occurred, on the date stated above, at 2.50 P.M.
The CAUSE OF DEATH was as follows:
Chronic myocarditis (Duration) [blank] yrs. 2 mos. [blank] ds.
Contributory (Secondary) Bronchial asthma (Duration) [blank] yrs. 2 mos. [blank] ds.
(Signed) Park A. Deckard [?] M.D.
12/13 1920 (Address) 709 N 3drd St.
18. LENGTH OF RESIDENCE (For Hospitals, Institutions, Transients and Recent Residents). [blank]
19. PLACE OF BURIAL OR REMOVAL Harrisburg Cemetery
DATE OF BURIAL Dec 15 1920
20. UNDERTAKER Arthur C. HAUCK
ADDRESS 1223 N 3rd St

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revised 16 Mar 14
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