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Case File: Mailahn Family (1912)
From Death Records of Outagamie County, Wisconsin – Vol 3 (Pre Oct 1907)
Certificate No 120 (01860)
[Link to original on Ancestry.com]
| # | Question | Answer |
| 1 | Full name of deceased | Lizzie Mailahn |
| 2 | Maiden name (if wife or widow) | [blank] |
| 3 | Color and sex | white-female |
| 4 | Race | Caucasian |
| 5 | Occupation of deceased | Housework |
| 6 | Age (years, months and days) | 14 yrs, 9 mos, 18 Dys |
| 7 | Name of father | Louie Mailahn |
| 8 | Birthplace of father | Germany |
| 9 | Name of mother | Augusta Mailahn |
| 10 | Birthplace of mother | Germany |
| 11 | Birthplace of deceased | Town of Ellington |
| 12 | Date of birth of deceased | May 19, 1892 |
| 13 | Condition (single, married, widowed, or divorced) | Single |
| 14 | Name of wife or husband of deceased | [blank] |
| 15 | Date of death | March 7th, 1907 |
| 16 | Cause of Death {Primary, Secondary} | Phthisis, Heart Failure |
| 17 | Duration of disease | Several months |
| 18 | Place of death | at home |
| 19 | Resident at time of death | Town Ellington |
| 20 | Was deceased ever a U.S. soldier or sailor | [blank] |
| 21 | Name of physician, coroner or justice | E. N. Sartell, M.D. |
| 22 | Residence of such person | Black Creek, Wis. |
| 23 | Name of undertaker or other person conducting burial | Rev. R. Hinnenthal |
| 24 | No. and date of burial permit | 20 – March 9th 1907 |
| 25 | Place of burial | Town Cemetery Black Creek |
| 26 | Date of certificate | March 8th 1907 |
| 27 | Date of registration | Apr 26, 1907 |
| 28 | Other important facts not related | [blank] |
