Shoemaker, Duane Edmond (? - 1918)
Surnames: Shoemaker, Arnold, Cole
----Source: Butler Township, Clark County, Wis. Death Records
Duane Edmond Shoemaker
Butler, Clark County, Wisconsin
STATE OF WISCONSIN
Penalty for Burying Without a Permit, $20 - $200
Township of Butler 1918
(City, Township or Village)
A satisfactory certificate of death having been furnished to me, as required by the laws of this State, permission is hereby given for the burial of Duane Edmond Shoemaker
Who died at Township of Butler in the county of Clark
On Oct 10, 1918 the cause of death being cold and influenza
Place of burial: Butler Cemetery
(Signed by) Arthur J. Feild
(Registrar, Deputy or Sub-Registrar)
Undertaker or person in charge (Sexton)
B. A. Cole, M. D.
Date of internment: Oct 12, 1918
(Name of Cemetery)
This permit must be delivered to the keeper of the cemetery where the burial occurs, and should be endorsed by him and returned to the local registrar of his district.
THIS "STUB" TO BE KEPT BY PERSON ISSUING PERMIT
1. Name of deceased: Duane Edmond Shoemaker
2. Place of burial: Butler Cemetery
3. Date and place of death: Oct 10 - 18 Town of Butler
4. Disease causing death: Cold & influenza
5. Cause of death given by: B. A. Cole, M.D.
6. Undertaker: B. A. Cole, M. D. (& illegible)
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