92 Paul Gerhardt Tonsing Death

STATE OF KANSAS State Board of Health—Division of Vital Statistics

STANDARD CERTIFICATE OF DEATH

1. PLACE OF DEATH: County City

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K! in a a hoepitel or inetitotion, iaetitotian, fire (Ifydoath oornred g, Ita NAUE k.Ua.1 ol abort and

Ward

2. FULL NAME. —..St,

(a) Residence. No... (r/aoal place of abode) e~0 Lenfth af realdonoe In oltx ar town jrhere death a e e a r r e d i i - j r .

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da. n o w lane In

-Ward (If nanreaidant, (ira city or town and etete.) B , If af forobra birth T__jrr»..

I Waa rfeceaaed erer a member of the Army, N » t j . or Marina Carp* of the Called State.? I

If eo, atata Organization

•— Rank

rVrlod af eerrlee..

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS COI.OB OB RACE

5. rltrurle. Married, Widowed. or Illroreesl (writ* U>e word)

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(or) WIFE of /Z* <• I

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DATE OF IIIRTII (monlb.day

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\ year) yCl - •*•-J7-

Month.

Year.

Day.

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8. Trade, profession, or particular . ^' kind of work done, aa aplnner, / . < # ^. ^X aawyrr, bookkeeper, etc. ._'_£....' ,.! ». Industry or l i m i n e in which "-J"—*-* J^» woik m done, aa alik mill, •. ' aaw mill, bank, etc /.f.ij:..!^. 10. Data deceased last worked at II. Total lime (year.) this orcur<*tioO/''(meotk and? / epent in this irflmn yrar) ,^1J:.-^:.^../I ... Ji..U...„- ... oceup •*—-?* yi=(II. UIRTfirLACE (city or town).. (Nlate or country)

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BIKT1IFLACE (city or town). (Htata or country) MAIDEN NAMK

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Ccn tribe, tory CHUM-I af !ropor£*n<'o not rel*t«d t o prtOa^poJ

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Name of o p o r a t l o a . i t / M ^ i i t i L j •ZAiictyA^*4.

Date

What test conflrmed dlaa-noalaf J^fiJif Wa. there i ::s. If drn(h wit" da« (o ntrrtutl caarves {vfolciur) flit In al*o tb« folAccident, *utclda, or

faomleMeT

I>ot« of i n j u r y „

Uaancr of Injury aSofortt of InJnry......-.....-— Wan iiJ-<-ii-«" or Injury In nny wny related to o«cup4>tioa of dtr* !"VV^g a^

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( S l « n e d ) - _ r - ? . y J l X - . d V - — y
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(fljx^eifr city or town, rouALy, and tUU) Hp*M-lfy whether Injury occurrcij hi Intluntry, In lioinr, or In pnbllo plftvco. , — . -y

If mo, »&rclt7

FILED / „ . , / .

!•>.£

. ll>*5c\ death I. auld

to hare occurred on the da»« atated above at _t?..*}._m. The principal ranae of death and related Sanaa, of tsaportaaao la ardar of oeaM war. a . f o l i o . . . ^Vt<,n..l

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irNDEUTAKlCTt (Add to.

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Ifberfl did Injury oeearT.

IirRTiTPLACK (city or town). -*f-J7--CT*:r (Htnte or country) 1? ^ t t x / ^ y ^ y a INFORMANT. -. . -V. ___ (Addrau) a t g jTr- g j Vr*-/

ItlTRIAU,CRKMA.TION, OR REMOVAL, , , I'laee .;itri>-t-%-^f>-— I>»te ~? ~

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I BKKKIIY CERTIFY. That I attended deeeaaed from I laat siitr hA<**^»llve on

If LESS than I ilar— hn or mla.

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IS. NAMK

DATE OF DEATH (month, day, and year)

.--?--£ir_

If married, widowed, or. dl»qreed" II! HHANI) of / / ' / J

IS.

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(Addreaa)..

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