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. 112
| Enumerator: J. M. Boyd CENTERVILLE BOROUGH
| 1.
| 10
| Aldora Rockwell
| 33
| F
| W
| married
| PA
| NY
| MA
| Keeping house
| April
| Consumption
| 33
|
| F Markham
| Note: Family of Person Sexton, aged 78, with grandson Clinton Rockwell, aged 14.
| 2.
| 66
| John Conner
| (75)
| M
| W
| single
| Ireland
| Ireland
| Ireland
| Farmer
| March
| Unknown
| 10
|
| F Markham
| ROME TOWNSHIP
| 15.
| 146
| Mary Wright
| 81
| F
| W
| widow
| Scotland
| Scotland
| Scotland
|
| Dec.
| Old age
| 42
|
|
| Note: Family of Robert P. & Agnes Randall, both born Scotland.
| 16.
| 190
| Earnest Sullt
| 9/12
| M
| W
| single
| PA
| PA
| IL
|
| Feb.
| Scarlet fever
| 9/12
|
| A P Waid
| 17.
| 205
| Sarah Sherman
| 65
| F
| W
| married
| NY
| RI
| RI
| Keeping house
| Oct.
| Tumor
| 20
|
| G L C[larktorn]
| Cause of Death [line "3"]Primary: Correctly stated; signed: G. L. Clark
| 18.
| 209
| Francis Magee
| 81
| M
| W
| married
| PA
| Ireland
| Ireland
| Farmer
| Sept.
| Paralyssis
| 81
|
| G L [Clarktorn]
| Cause of Death [line "4"]Primary: " [Correctly stated]; signed: " [G. L. Clark]
| 19.
| 209
| Nancy Magee
| 77
| F
| W
| widow
| PA
| Ireland
| Ireland
| Keeping house
| Jan.
| Paralyssis
| 77
|
| Frank [torn]
| 20.
| 246
| Leroy Hopkins
| 10/12
| M
| W
| single
| PA
| NY
| PA
|
| Dec.
| Consumption
| 10/12
|
| A P W[aid?torn]
| Note: Family #246 includes son Leroy Hopkins, aged 4.
| 21.
| 248
| John Heliker
| 91
| M
| W
| widower
| NY
| Germany
|
| Farmer
| July
| Old age
| 37
|
| A P Waid
| 22.
| 272
| Alphues Holebrook
| 75
| M
| W
| married
| VT
| CT
| VT
| Farmer
| Nov.
| Dropsy
| 50
|
| A P Waid
| Note: At family #272, surname is spelled Holebrok.
| 24.
|
| Madaline Scott
| 49
| F
| W
| married
| PA
|
|
|
| April
| Pneumonia
|
|
| F. S. Markham
| Additions from Physicians Returns
| 28.
|
| Anna Whitmon
| 25
| F
| W
| married
| US
| US
| US
| Farmers Wife
| April
| Heart Disease
|
|
| C E Cobb
| next E.D.
| |