Kathrina Chaloupka Death Registry Entry

Jones County Register of Deaths, Book 1: 92, County Recorder's Office, Anamosa, IA

 

No. 

Date of Report

 

1. Name

2. Sex and Color

1. Age

2. Occupation

Date of Death

Single, Married, Widower or Widow

1. Nationality

2. Where Born

Month  Day Year A. M. or P. M.
1081 10-3-95 [3 Oct 1895] 1. Kathrina Chaloupka

1. Year Month Days

    78 - 1 - 

5 30 95

1 P.M.

M 1.
2. Sex, F Color, W 2. Housewife 2. Bohemia

 

 

No. Years Resident in this State

1. Place of Death

2.Cause of Death

1. Complication

2. Duration of Disease

1. Place of Burial

2. Date of Burial

Name and Residence of Physician

Returning Certificate

37 1. Madison Twp. 1. Erysipelas 1. Wyoming M H Calkins
2. Dropsy 2. 17 Mos. 2. 1-2-95 [2 Jan 1895]*

* Date is 2 Jan 1895.  The 1 could also be a 6.  June would be the appropriate month of burial based on the death date of 30 May 1895.  30 May 1895 has been confirmed as the date of death per her obituary.*

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