DEATH: CHALK, Mary Anna, 1915, Campbell Co., KY
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Contributed for use in US GenWeb Archives:
Submitted by E-mail Registry Submitter: Peggy A o k i
 <http://www.genrecords.net/emailregistry/vols/00002.html#0000389>
Date: October 01, 1998  
Subject: DEATH: CHALK, Mary Anna, 1915, Campbell Co., KY
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Commmonwealth of Kentucky
State Board of Health
Bureau of Vital Statistics
CERTIFICATE OF DEATH

file # 534

1. Place of Death: County- Campbell, Inc. Town- Gubser Mills,
Registration District No.- 185, Primary Registration District No.- 5432

2. Full Name: Mary Anna Chalk
3. Sex: Female
4. Color or Race: White
5. Married
6. Date of Birth: Dec. 6, 1835
7. Age: 79 years, 1 month, 18 days
8. Occupation: Housework
9. Birthplace: Germany
10. Name of Father: Steve Sheanshang
11. Birthplace of Father: Germany
12. Name of Mother: Don't know
13. Birthplace of Mother: Don't know
14. The above is true to the best of my knowledge:
	Informant: Jos. Chalk, Gubser Mills, KY
15. Filed: (blank)
16. Date of Death: Jan. 24, 1915
17. Cause of Death: (unreadable--perhaps "peritonitis")
     Contributory: Senility
     Signed: F.E. Kinsey (?) Jan 14, 1914 , ????, KY
18. Length of residence: blank
19. Place of Burial: Gubser Mills, KY  Date: Jan 27, 1915
20. Undertaker: P.A. Erschell, Alex. KY

Note: Mary Anna was born in Raedersdorf, Alsace, France. Her father
(born there also) was "Etienne Tschientshan" on his birth certificate
(an on hers). Her mother was Gertrude Meister, also of Raedersdorf,
France.

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