KEY: 1 Family # on Schedule 1. 2 Name of deceased. 3 Age. 4 Sex. 5 Color. 6, 7, 8 Single, Married, Widowed/Divorced. 9 Place of birth. 10 Birthplace of father.
11 Birthplace of mother. 12 Profession, trade, or occupation. 13 Month of death. 14 Disease or cause of death. 15 Length of residence in the county.
16 Where disease contracted. 17 Attending physician.
1
| 2
| 3
| 4
| 5
| 6, 7, 8
| 9
| 10
| 11
| 12
| 13
| 14
| 15
| 16
| 17
| S.D. 10, E.D. 111
| Enumerator: John D. McLatchey [ROCKDALE TOWNSHIP]
| 1.
| 16
| Christian Steinhoff
| 60
| M
| W
| married
| Hanover
| Hanover
| Hanover
| Farmer
| March
| Pneumonia [written over:] Lung Fever
| 26
|
| Alonzo Birchard
| 2.
| Death occurred outside district at Town: Bloomfield; County: Crawford; State: Pennsylvania
| Cause of DeathPrimary: | 3.
| 32
| Fianna Watson
| 8
| F
| W
| single
| PA
| PA
| OH
|
| March
| Scarlet fever
| 4
|
| J. H. Kirk
| Cause of DeathPrimary: Malignant Scarletina; Immediate: Same; signed: J. H. Kirk
| 4.
| 32
| Rosie --
| 4
| F
| W
| single
| PA
| PA
| OH
|
| March
| Scarlet fever
| 4
|
| J. H. Kirk
| Cause of DeathPrimary: " [Malignant Scarletina]; Immediate: " [Same]; signed: J. H. Kirk
| 5.
| 34
| Nellie E Clark
| 7
| F
| W
| single
| NY
| PA
| PA
|
| Feb.
| Scarlet fever
| 2
|
| Wm. P. Biles
| Cause of DeathPrimary: Scarletina Maligna; Immediate: Same; signed: Wm P Biles
| 6.
| 34
| Jennie P. --
| 3
| F
| W
| single
| NY
| PA
| PA
|
| Feb.
| Scarlet fever
| 2
|
| Wm. P. Biles
| Cause of DeathPrimary: " [Scarletina Maligna]; Immediate: " [Same?]; signed: Wm P. Biles
| 7.
| 45
| Joel Brown
| 59
| M
| W
| widower
| VT
|
|
| Farmer
| March
| Hernia
| 40
|
| J. H. Kirk
| Cause of DeathPrimary: Organic Stricture of Bowels; Immediate: Inflamation; signed: J. H. Kirk
| 8.
| 76
| Jane Jervis
| 74
| F
| W
| widow
| PA
| Ireland
| Ireland
| At home
| June
| General debility
| 40
|
|
| Remark: Cervis Jane on line 8 was not attended by a Physician and the only answer I could get in disease or cause of death was (old age) I thought the above named cause would apply the best of anything I could get
| 9.
| 80
| Willis Wheeler
| 4/12
| M
| W
| single
| PA
| NY
| PA
|
| Dec.
| Typhoid Pneumonia
| 4/12
|
| H. C. McClintock
| 10.
| 103
| Helke Gerrish
| 60
| F
| W
| married
| Hanover
| Hanover
| Hanover
| Keeping house
| July
| Thrown from carriage
| 23
|
| J. Hand M.D. Gray
| 11.
| 124
| Hannah Bertram
| 72
| F
| W
| widow
| Hanover
| Hanover
| Hanover
| At Home
| Feb.
| Lung Fever
| 12
|
| M.D. Gray
| Note: Family of Henry Mathews, with wife Caroline, aged 31 (mother born Hanover).
| 12.
| 133
| Georgia Wilson
| 3
| M
| W
| single
| PA
| PA
| PA
|
| Jan.
| Scarlet Fever
| 3
|
| Gray M.D.
| 13.
| 174
| James S Brice
| 63
| M
| W
| widower
| NY
| (NY)
| (NY)
| Blacksmith
| Dec.
| Congestion of Lungs
| 14
|
| Birchard A. D.
| Note: Family of John W. Finney, with wife Fannie C., aged 28 (mother born NY).
| 14.
| 176
| Lydia A Hyatt
| 45
| F
| W
| married
| PA
| MA
|
| At home
| Oct.
| Congestion of Lungs
| 1/12
| Mich.
| Gray M.D.
| Note: Family of Samuel Sherlock, aged 43, born PA (parents born MA).
| 15.
| 197
| (Infant) Hammond
|
| M
| W
| single
| PA
| PA
| PA
|
| Jan. 21
| Still Birth (Mother fell)
|
|
| Wilson Jacob
| 16.
| 201
| Henry Wise
| 44
| M
| W
| married
| PA
| PA
| Scotland
| Laborer
| Nov.
| Heart Disease
| 44
|
| Davis Jno
and Coburn
| Death occurred outside district at Town: President; County: Venango; State: Pennsylvania
| 17.
| 327
| Laura Morton
| 46
| F
| W
| married
| NY
| CT
| CT
| Keeping house
| Dec.
| Consumption
| 40
|
| Morton Fra[torn]
| 18.
| 337
| Henry A Bunting
| 42
| M
| W
| married
| PA
| PA
| PA
| Farmer
| Oct.
| Lung Fever
| 42
|
| Gray[torn]
| 19.
| 343
| Mary Jervis
| 70
| F
| W
| married
| PA
| Ireland
| Ireland
| Keeping house
| April
| 70
|
| Gray Jno[torn]
| Remark: I was instructed by J. H. Kirk and William P. Biles to fill blank on other side and affix their signatures. -- Have not been in communication with other attending Physicians signed: John D. McLatchey, Enumerator
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