Registration of Deaths. Racine, Wisconsin - No. 00887 - June/july 1905
1. Full name of deceased Child of Uhrenholt ["Mary" added above]
2. Maiden name (if wife or widow) -
3. Color and sex White - female
4. Race Danish
5. Occupation of deceased -
6. Age (years, months and days) -
7. Name of father Moen Uhrenholt
8. Birthplace of father Denmark
9. Name of mother Tillie Uhrenholt
10. Birthplace of mother Denmark
11. Birthplace of deceased Racine
12. Date of birth of deceased Jan. 28 - 1905
13. Condition (single, married, widowed, or divorced) -
14. Name of wife or husband of deceased -
15. Date of death June 28. 1905
16. Cause of death (primary, secondary) Stillborn, premature birth
17. Duration of disease -
18. Place of death 2109 Clarence Ave.
19. Residence at time of death 2109 Clarence Ave.
20. Was deseased ever a U.S. soldier or sailor? -
21. Name of physician, coroner or justice J. Meachem Jr.
22. Residence of such person -
23. Name of undertaker or other person condueting burial N. P. Hanson, Co.
24. No. and date of burial permit 5989 June 28 1905
25. Place of burial Mound Cem.
26. Date of certificate June 28 - 1905
27. Date of registration July 1st - 1905
28. Other important facts not related Fred Pyister H.O.
Registration of Deaths. Racine, Wisconsin - No. 00888 - June/july 1905
1. Full name of deceased Thelli Uhrenholt
2. Maiden name (if wife or widow) Christensen
3. Color and sex White - female
4. Race Danish
5. Occupation of deceased -
6. Age (years, months and days) 26 years
7. Name of father J. Kristensen
8. Birthplace of father Denmark
9. Name of mother Christensen
10. Birthplace of mother Denmark
11. Birthplace of deceased Denmark
12. Date of birth of deceased April 1. 1879
13. Condition (single, married, widowed, or divorced) Married
14. Name of wife or husband of deceased Mogens Uhrenholt
15. Date of death July 2. 1905
16. Cause of death (primary, secondary) Acute (unreadable)
17. Duration of disease 5 days
18. Place of death 2109 Clarence Ave.
19. Residence at time of death 2109 Clarence Ave.
20. Was deseased ever a U.S. soldier or sailor? -
21. Name of physician, coroner or justice John Meachem Jr.
22. Residence of such person Racine, Wis.
23. Name of undertaker or other person condueting burial N. P. Hanson, Co.
24. No. and date of burial permit 5994 July 5, 1905
25. Place of burial Mound Cem.
26. Date of certificate July 5 - 1905
27. Date of registration Aug. 1 - 1905
28. Other important facts not related Fred Pyister H.O.
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