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DEATH CERTIFICATES

STATE OF OHIO
BUREAU OF VITAL STATISTICS
CERTIFICATE OF DEATH

County of Hamilton
Registration District No. 2532                                     File No. 21892
Village of Silverton
FULL NAME:  Josephine Bloomer

PERSONAL AND STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH
SEX: Female 4. COLOR OR RACE: White DATE OF DEATH: April 30, 1911
DATE OF BIRTH:  Nov. 16, 1909 I HEREBY CERTIFY, That I attended deceased from Apr. 23, 1911 to Apr. 30, 1911 and that death occurred, on the date stated above, at 1:30 p.m.  The CAUSE OF DEATH was as follows:
Entero Colitis
(Signed) A. O. Sprague M. D.
Silverton, O.
DATE OF BIRTH: 1863 - 15th Nov?
AGE: 1 years 5 months 14 days
SINGLE, MARRIED, WIDOWED OR DIVORCED:
Single
BIRTHPLACE:  Blue Ash, Ohio
OCCUPATION:  None PLACE OF BURIAL or REMOVAL:
Reading, Catholic
NAME OF FATHER: John Bloomer DATE OF BURIAL: May 2, 1911
BIRTHPLACE OF FATHER:  Ohio UNDERTAKER: H. Ihlendorf Co.
ADDRESS: Reading, O.
MAIDEN NAME OF MOTHER:  Mary Kneipp
BIRTHPLACE OF MOTHER:  Ohio
THE ABOVE STATED PERSONAL PARTICULARS ARE TRUE TO THE BEST OF MY KNOWNEDGE AND BELIEF:
(Informant) John Bloomer
(Address) Silverton, O.

(Contributed by Lori Chaffin from family records)

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