Here it is the beginning of a new work week for many people and I want to start this week off by transcribing a document that is important to my family research.
Amanuensis Monday is a weekly blog theme that was started by John Newmark, the author of TransylvanianDutch blog. John defines Amanuensis as "A person employed to write what another dictates or to copy what has been written by another." I also appreciate the good work and format examples of San Diego genealogist Randy Seaver of the blog Genea-musings. Thanks guys.
Transcribing helps me to learn what a document contains. I have learned over time that I have a tendency to "skim" over an item; a bad trait for a researcher who needs to learn even the smallest details documented records contain. Transcribing helps me to slow down and "smell the roses."
The document I am transcribing today is the Death Certificate of Alfred M. Johnson (1893-1931). Alfred was my paternal grandfather. This is a form filled out primarily by typed-in information. I will present the typed information in italics to help provide clarity. I am not able to imitate the exact format but will offer this transcription as a "list" instead. Fields that are left blank on the original will also be left blank on the transcription. My comments will show with square brackets [ ].
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| IMAGE: Death Certificate for Alfred M. Johnson [1] Certified copy held by Darlene M. Steffens |
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
S. F. No. 825-1921. Approved as to Form by Dept. of Efficiency. 9689.
Washington State Board of Health
-------
BUREAU OF VITAL STATISTICS
CERTIFICATE OF DEATH
1. PLACE OF DEATH Record No. 1857 [hand stamped]
County of KING [hand stamped] Registered No. 1944 [hand stamped]
City or Town of SEATTLE [hand stamped]
Registration Dist. No. __ No. Swedish Hospital St., __Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Length of residence in city or town where death occurred _yrs. 2 mos. _ds.
How long in U.S. if of foreign birth? __yrs. __mos. __ds.
How long in U.S. if of foreign birth? __yrs. __mos. __ds.
2. FULL NAME ALFRED MAREM JOHNSON 525 [handwritten]
(a) Residence: No. 9418 - 14th Ave. S.W. St., __Ward.
(Usual place of abode) (If nonresident give city or town and State)
PERSONAL AND STATISTICAL PARTICULARS
3. SEX Male
4. COLOR OR RACE White
5. Single, Married, Widowed or Divorced (write the word) Married
5a. If married, widowed, or divorced HUSBAND of (or) WIFE of Olena Johnson
6. DATE OF BIRTH (month, day, and year) De. 2, 1893 [Dec.]
7. AGE Years 37 Month 5 Days 27 If LESS than 1 day,__hrs,or__min.
OCCUPATION
8. Trade, profession, or particular kind of work done,
as spinner, sawyer, bookkeeper, etc. Common Laborer
9. Industry or business in which work was done, as silk
mill, saw mill, bank, etc. Common
10. Date deceased last worked at this
occupation (month and year) May 22, 1931
11. Total time (years) spent in this occupation 20 yr.
12. BIRTHPLACE (city or town) Lake Preston
(State or country) South Dakota
FATHER 13. NAME William Johnson
14. BIRTHPLACE (city or town) ___
(State or country) Denmark
MOTHER 15. MAIDEN NAME Maria Johnson
16. BIRTHPLACE (city or town) Dain County [Dane]
(State or country) Wisconsin
17. Informant William Johnson
(address) Rt. 3, Kent, Wash.
18. BURIAL, CREMATION, OR REMOVAL
Place Kent Date May 29, 1931
19. Undertaker C.G. Chittenden
(Address) Kent, Washington
20.FILED May 30, 1931 [handstamped] E. T. HANLEY, M. [handstamped]
Registrar.
MEDICAL CERTIFICATE OF DEATH
21. DATE OF DEATH (month, day, and year) May 29, 1931
22. I HEREBY CERTIFY, That I attended deceased from May 24, 1931 to May 28, 1931
I last saw him alive on May 28, 1931, death is said
to have occurred on the date stated above, as 1 Am 86a [handwritten]
22. I HEREBY CERTIFY, That I attended deceased from May 24, 1931 to May 28, 1931
I last saw him alive on May 28, 1931, death is said
to have occurred on the date stated above, as 1 Am 86a [handwritten]
The principal cause of death and related causes of importance in order of onset were as follows:
Meningitis Cerebro Spinal (not epidemic) Date of onset __
Contributory causes of importance not related to principal cause:
Chronic Otitis Media
Name of operation May 25 Date of ______
What test confirmed diagnosis? Abscess on Brain Was there an autopsy? __
23. If death was due to external causes (violence) fill in also the following:
Accident, suicide, or homicide? __ Date of injury __, 19_
Where did injury occur? _____
(Specify city or town, county, and State)
Specify whether injury occurred in industry, in home, or in public place.
___________________
Manner of injury ___
Nature of injury ___
24. Was disease or injury in any way related to occupation or deceased? No
If so, specify _____
(Signed) S. Maimon Samuels, M.D.
(Address) 1622 Medical & Dental Bl.
Source:
1. Washington State Board of Health, death certificate no. 1857. Alfred Marem Johnson (1931); Washington State Department of Health, Tumwater.
Meningitis Cerebro Spinal (not epidemic) Date of onset __
Contributory causes of importance not related to principal cause:
Chronic Otitis Media
Name of operation May 25 Date of ______
What test confirmed diagnosis? Abscess on Brain Was there an autopsy? __
23. If death was due to external causes (violence) fill in also the following:
Accident, suicide, or homicide? __ Date of injury __, 19_
Where did injury occur? _____
(Specify city or town, county, and State)
Specify whether injury occurred in industry, in home, or in public place.
___________________
Manner of injury ___
Nature of injury ___
24. Was disease or injury in any way related to occupation or deceased? No
If so, specify _____
(Signed) S. Maimon Samuels, M.D.
(Address) 1622 Medical & Dental Bl.
[THE SEAL OF THE STATE OF WASHINGTON 1889]
DOH 01-003 (5/99)
-------- transcription ends --------Source:
1. Washington State Board of Health, death certificate no. 1857. Alfred Marem Johnson (1931); Washington State Department of Health, Tumwater.
The URL for this post is: http://homefolktales.blogspot.com/2016/03/amanuensis-monday-death-certificate-of.html
Please comment regarding this post on the website by clicking the URL above and then use the "Comments" link at the bottom of each post. Or contact me by email at dsteff4246[at]gmail[dot]com. Thank you. I am glad you stopped by.
Please comment regarding this post on the website by clicking the URL above and then use the "Comments" link at the bottom of each post. Or contact me by email at dsteff4246[at]gmail[dot]com. Thank you. I am glad you stopped by.
Copyright (c) 2016, Darlene M. Steffens. All rights reserved.
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