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- [S24] Henry Hern?, Death Certificate: Percy, William Andrew - 1936, (Nebraska Department of HHS Finance & Support), 11 Nov 1936, G12054. (Reliability: 3).
6. DATE OF BIRTH (mo.) March (day) 15 (year) 1860...
12. Birthplace {City or Town and State or Country Boston Mass.
- [S24] Henry Hern?, Death Certificate: Percy, William Andrew - 1936, (Nebraska Department of HHS Finance & Support), 11 Nov 1936, G12054. (Reliability: 3).
OCCUPATION
8. Trade, profession or particular kind of work down, as spinner, sawyer, bookkeeper, etc. Painter...
10. Date decesaed last worked at this occupation (month and year) Aug. 1936
11. Total time (years) spent in this occupation Lifetime
- [S24] Henry Hern?, Death Certificate: Percy, William Andrew - 1936, (Nebraska Department of HHS Finance & Support), 11 Nov 1936, G12054. (Reliability: 3).
1. PLACE OF DEATH
County Saline
Township (blank)
City Wilbur, Nebr. No. (blank) Street (blank)...
21. DATE OF DEATH Wm Andrew Percy Nov 9, 1936
22 I HEREBY CERTIFY, That I attended deceased from Sept 1, 1936, to Nov. 9, 1936
I last saw him alive on Nov 8, 1936, death is said to have occurred on the date stated above at 3:45 a.m.
The principal cause of death and related causes of importance in order of onset were as follows:
Cirrhosis of Liver / Date of Onset IMPORTANT july 1, 36
Contributory causes of importance not related to principal cause:
Diabetis
- [S24] Henry Hern?, Death Certificate: Percy, William Andrew - 1936, (Nebraska Department of HHS Finance & Support), 11 Nov 1936, G12054. (Reliability: 3).
18. BURIAL, CREMATION, or REMOVAL
Place Wilber Date Nov. 10, 1936
19. UNDERTAKER Fred Shimerda (Address) (blank)
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