| WISCONSIN STATE BOARD OF HEALTH ORIGINAL CERTIFICATE OF DEATH # 0026734 | |
| NAME OF DECEASED: | Jennie L. Emerson |
| PLACE OF DEATH: | 1214 Center ST. Racine, Racine County |
| USUAL RESIDENCE: | 1214 Center St. Racine, Wisconsin |
| SEX: | Female |
| COLOR OR RACE: | White |
| MARITAL STATUS: | Married |
| DATE OF BIRTH: | December 20, 1866 |
| PLACE OF BIRTH: | Racine County, Wisconsin |
| AGE: | 85 Years |
| KIND OF BUSINESS: | Housewife |
| FATHER'S NAME: | William J. Howard |
| MOTHER'S MAIDEN NAME: | Edith Dawson |
| INFORMANT: | Elmer Emerson, Husband |
| DATE OF DEATH: | December 15, 1952 |
| CAUSE OF DEATH: | Bronchitis and Chronic Myocarditis |
| ANTECEDENT CAUSES: | Secondary Anemia Weakness-wouldn't eat |
| CERTIFICATION: | I hereby certify that I attended the deceased from August, 1952 to December 15, 1952, that I last saw the deceased alive on December 12, 1952, and that death occurred at 4 P.M., from the cause and on the date stated above. |
| PHYSICIAN: | H. J. Brehm, Sr. 1401 Grand Avenue |
| BURIAL: | Calvary Cemetery Racine, Wisconsin |
| DATE OF BURIAL: | December 18, 1952 |
| FUNERAL DIRECTOR: | Dan Strouf Racine, Wisconsin |
Comment and discuss