Color:       White

Sex:       Male

Age:       About 70 years

Name of Father of Deceased:

Name of Mother of Deceased:

Occupation:      Laborer

Place of Birth:

Name of Wife of Deceased:

Name of Husband of Deceased:

Date of Birth and Date of Death:  
   Tuesday, Nov. 18, 1884
       No Post Mortem

Cause of Death:     General Paralysis.  Was dead when I arrived

Name of the place, town or township,  Town of Gillett, Oconto Co.
and county in which the person died:

Name and Location of Burial Ground in  Gillett Town Cemetery 
Which Interred:

Name of Person Return Certificate:  P. O’Keef, M.D.

Residence of Such Person:   City of Oconto 

Date of Certificate:     November 18th 1884

Date of Registration:    December 31st, 1884