Certificate of Death - Physician's Form: Undertaker's Certificate and Record of Death of Anna Sarire Weber, 1914

Title

Certificate of Death - Physician's Form: Undertaker's Certificate and Record of Death of Anna Sarire Weber, 1914

Description

Death certificate Anna Sarire Weber completed by Dr. A. Louise Klehm. Information on the certificate includes: date of birth: 1912-01-31; date of death: 1914-01-12; place of death: Tessville; place of burial: St. Peter's; undertaker: N. P. Weimeschkirch, 7066 N. Clark St.; father: Michael Weber, born in Chicago; mother: Carrie Becker, born in Chicago; and cause of death: "Burned by falling in hot ashes (lower half of body and left arm)" and contributory (secondary): "Shock - Inhalation of hot gas fumes". The backside of the certificate gives instructions and suggested causes of death.

Date

1914-01-14

Rights

No Copyright - United States

Access Rights

If you would like a reproduction or a high resolution image of this item, submit a Skokie Historical Archive Image Usage Request to the Skokie Heritage Museum.

Medium

death certificates

Source

Skokie Historical Society, Skokie, Illinois

Spatial Coverage

Skokie -- Illinois -- United States; Lincolnwood -- Illinois -- United States

Citation

“Certificate of Death - Physician's Form: Undertaker's Certificate and Record of Death of Anna Sarire Weber, 1914,” Skokie History Digital Collections, accessed August 10, 2020, https://skokiehistory.omeka.net/items/show/996.