1904
POLK COUNTY DEATH
CERTIFICATES


 






 

Lucretin Nelson
Female    White
Widow
Informant:  W.T. May
DOD:   Jan 5, 1904
Buried:   McMinnville, OR    Jan 7, 1904
Undertaker:   W.T. May


Simon George Howard
Male    White
DOB:  June 30, 1904
Single
Birthplace:  Monmouth, OR
Father: Claude G. Skinner
Birthplace:  Tole co. Kentucky
 Mother:  Ethel E. Hall
Birthplace:  Dallas, OR
Informant:  Claude G. Skinner   Independence, OR
DOD:  Jan 5, 1904  12:30am
Cause:  Pneumonia Oedema of lungs
Duration: 14 days
Buried:  Independence June 6, 1904
Undertaker W. L. Bird??



5 miles SW of Dallas
Mary Bailey Wright
Female    White
DOB: Nov. 30, 1848
Married
Birthplace: IL
Father: George Haworth
Birthplace: TN
Mother:  Mary Thornton
Birthplace:  OH
Occupation:  Tailor
Informant:  Levi Wright  Dallas, OR
DOD: Jan 14, 1904   5pm
Cause:  acute appeudicitus
Duration:  6 days
MD Wm S. Cary of Dallas, OR



Falls City 2 miles NE
Esaac Hughes
Male    White
DOB:  May 20, 1881
Single
Birthplace:  Falls City, OR
Father:  Isaac Hughes
Birthplace: Wales
Mother:  Mary Roberts
Birthplace: Wales
Occupation:  Farmer
Informant: L Pfandhoefer, MD  Falls City, OR
DOD: January 15, 1904  10pm
Cause:  Shooting himself
(accidently as much as can be ascertained
Duration: 2 days
Buried: Ioof Cemetery  Falls City, OR January 17,1904



Independence
Ann Macaulay
Female  White
DOB: September 7, 1830
Widow
Birthplace:  Chester England
Father: Joseph Fodess
Birthplace: Chester England
Mother: Auria Lightfoot
Birthplace: Chester England
Occupation:  House Keeping
DOD: January 31, 1904 12:15 am
Cause:  Intenstinal Obstruction
Duration 4 days
EL Ketchewer MD
Buried: Portland, OR Feb 5 or 6 1904
Undertaker:   Josse & Bice Independence, OR



Weril ??
Male   White
DOB: July 22, 1831
Single
Birthplace:  Rome, NY
Father: Wm Norton
Occupation:  Minister of the Gospel
Informant:   Jas R. Shepard   Salem, OR RFD #1
DOD: February 7,1904  approx: 6:30 am
Cause:  Consumption
Duration:  about 1 year
Buried:  Zena, OR  2/8/1904



Henry Lturges
Male   White
Married
Occupation:   Printer
DOD: February 13,1904
Cause: Chronic Brights Disease
FE Smith MD, Salem, OR


Perrydale
Ebenejer C Keyat
Male   White
DOB:  November 15, 1827
Married
Birthplace:  New York
Father:  Gideon Keyt
DOD:  February 1, 1904  4:15 am
Cause: Senile Decay
Duration: about 1 year
RC Hunter MD
Buried: Bethel February 19, 1904
Undertaker:  W. Chapman, Dallas


Dallas
David Cosper
Male   White
DOB: October 29, 1828
Married
Birthplace:  OH
Father:  Daniel Cosper
Birthplace:  PA
Mother:   Margaret Marr
Birthplace: PA
Informant:  H.B. Cosper, Dallas OR
DOD:  February 18, 1904  11 am
Cause: Pneumonia
Duration:   8 days
Wm S Cary MD, Dallas OR



Falls City
Maggie M Mervin
Female   White
Married
Birthplace:  Kansas
Father: Matthews Miller
Birthplace: OH
Mother:    Sarah  Hamar
Brthplace:  Indiana
DOD: February 16, 1904
Cause: Embolism
Duration: 14 days
L. Pfandhoefer MD Falls City OR
Usual residence:  Watkiins’ Mill
Buried:  IOOF Cemetery

Independence
Gilbert Mc Cabe
Male   White
Single
Father:   P.H. Mc Cabe
Occupation: Laborer
Informant:  Thos Pomeroy
DOD: March 5, 1904
Buried:  IOOF Cemetery
Undertaker:  H. St. Jasperson, Independence, OR



Independence
Curtis Herbert Baker
Male    White
DOB:  September 27, 1882
Single
Birthplace: Neosho MO
Father:   Marcus A. Baker
Birthplace:  Dayton, OH
Mother:  Lizzie Roeden
Birthplace:  Near Mt. Vernon MO
Occupation:  Labor
Informant:  Arthur G. Baker, Independence,  OR
DOD:   March 5 1904
Buried:  IOOF Cemetary
Undertaker:  H H Jasperson, Independence


Independence
Alfred Henderson Simpson
Male    White
DOB:  January 30, 1841
Married
Birthplace: Lawraence Co. AR
Father:  R. William Simpson
Birthplace:  Germany
Mother:  Rebbecca Lasiter
Occupation:  Farmer
Informant:  Reuben H. Simpson, Monmouth OR
DOD:  April 11, 1904   9 pm
Cause: Brights Disease  Paralysis



Monmouth
Leah Nichols
Female    White
DOB:  December 25, 1823
Widow
Birthplace: Kambridge Maryland
Father: Heny Treago
Birthplace:  England
Mother???
Birthplace:  England
Informant: Lala Nichols, Monmouth, OR
DOD:   March 14, 1904    1 am
Cause: Bronchitis
Duration:  10 years
Contributory:  Old age
Buried:   Monmouth   March 15, 1904
Undertaker:  Jasperson, Independence



Independence
10 Miles SW
Anna M Bigler
Female   White
DOB:  March 10, 1828
Widowed
Birthplace:  Switzerland
Father: John Lehsnew
Birthplace:  Switzerland
Mother:  ??? Yoggi
Birthplace:  Switzerland
Occupation:House Work
DOD:  March 20, 1904  8am
Cause:  Chronic Asthma, liver & Kidney disease
Buried:  Amity, OR   March 23, 1904
Undertaker:   HH Jasperson, Indp


Independence
Hawisah Miller
Female    White
Widow
Birthplace:  IN
Father: ??? Maharr
Birthplace: IN
Mother ???
Birthplace:  England
DOD:   March 23, 1904  6 am
Cause:  Dropsey & heart


Mers Samuel T. Lobach
DOB:   Feb 14, 1826
Married
Birthplace: NY
Father:  Joseph ?unison
Birthplace:  New Jersey
Mother:  Margaret Galtry
Informant:   S.T. Lobach
DOD:   March 28, 1904  8 am
Cause: Pneumonia
Buried:  Zena, OR  March 29, 1904
Undertaker:   W Rigdon, Salem



Lerm E. Ketchum
Male    White
DOB:  Jan 10, 1832
Married
Birthplace:  NY
Father: Joes Ketchum
Birthplace:  NY
Mother:  M Hodges
Birthplace:  NY
Occupation: Farmer
DOD:  March 29, 1904  2 am
Cause:  Permicious Annersia
Buried:  IOOF Cemetery, Independance, OR
Undertaker:  H. H. Jasperson, Independance


Dallas
Elsie Pierce
Female   White
DOB:  1886
Single
Informant:  B. H. CcCallon MD
DOD April 7, 1904
Cause:  Pneumonia Complications & Measles


Dallas
Enoch L. Ingalls
Male   White
DOB:  July 11, 1831
Married
Birthplace:   Bangor Maine
Occupation:  Mechanic
Informant: Mrs Ingalls, Dallas
DOD:  April 7, 1904
Cause:  Hemaplegia


Dallas
Leta Peirce
Female   White
DOB:  1896
Single
Informant:  B H McCallon MD, Dallas
DOD:  April 10, 1904  4:00am
Cause:  Pneumonia Complicating Measels


Michigan
Maria Haase
Female    White
DOB:  April 1, 1815
Married
Birthplace:  Germany
DOD:  April 10, 1904
Buried:  Zena   April 11, 1904
Undertaker:   W. Rigdon, Salem


Dallas--2 miles N.
Sarah Ann Dunlap
Female    White
DOB:  June 11, 1843
Married
Birthplace:  Winchicomb, England
Father:  Elisha Hughes
Birthplace:  Winchicomb, England
Mother:  Martha Philkuos
Birthplace:  Winchibomcb, England
Informant:  Elisha Phillips
DOD:  April 14, 1904  4:00am
Cause:  Accute Tuberculosis
L.S. Woods MD, Dallas, OR
Buried:  Dallas Cemetery    April 15, 1904
Undertaker:  L. Chapman, Dallas, OR


Mary Ann Anderson
Female White
1829
Widow
Birthplace Missiour
Mother:  Mary A. Riggs
DOD April 15, 1904
Cause:  Apoxley


Addrew Podvin
Male White
1885
Single
Birthplace MN
Father:  Jos Podvin
Birthplace US
Mother:  Nettie Polly
Birthplace:  Italy
DOD:   May 15, 1904  2 am
Cause:  Peritonitis


Claud D. Simpson
Male White
DOB:  May 22, 1880
Single
Birthplace:  Polk Co. OR
Father R. H. Simpson
Birthplace:   Polk Co., OR
Mother:  Miram A. Hener
Birthplace:  Polk Co., OR
Occupation:  School Teacher
DOD May 21, 1904  7 pm
Cause:  Typhoid Feaver


F.R. Weiden
Male White
DOB: Jan 28, 1839
Married
Birthplace:  Ireland
Occupation:  Farmer
DOD:  May 21, 1904   5 am
Cause:  Rhemotism


Monmouth
John A. Knower
Male White
DOB Nov 25, 1824
Father:  John A. Knower
Occupation:  Minister
DOD:  June 10, 1904 6am
Cause:  La Grippe


Falls City
Mary J. Syron
Female White
DOB:  May 10, 1827
Married
Birthplace:  Albana, OH
Father:  William Franklin
Birthplace NJ
Mother:  Ackermann
DOD:  June 19, 1904 7pm
Cause:  Paralysis
Buried:  Odd Fellows Cemetery


Falls City, OR
Ettia Mather
Female White
DOB:  January 19, 1880
Married
Birthplace:  Cadillac, Mich
Father:  W.H. Livingston
Birthplace:  NY
Mother:  Addie Micnatt
Birthplace:  IL
DOD:
June 25, 1904 6pm
Cause:  Puerperal Septicaemia
Buried:  City


Falls City
Not Named
Female White
DOB:  July 2, 1904
Birthplace:  Coast Range Mill
Father:  John H. Vernon
Birthplace:  Linn Co. OR
Mother:  Minnie Piatt
Birthplace:  Linn Co., OR
DOD:  July 2, 1904  11pm
Cause:  Inanition


Monmouth
Mary White
Female White
Widow
Birthplace:  Aberden Co. Scotland
Father:  John Wilson
Birthplace:  Aberden Co. Scotland
Mother:  Mary Yongson
Birthplace:  Aberden Co. Scotland
DOD:  July 7, 1904 3 pm
Cause:  Uremic poisoning and Arthroma
Contributory:  Brights Disease


Mathias Kubin
Male White
DOB:  Dec 8, 1821
Married
Birthplace:  Bohemia Aus
Fathr Moseph Kubin
Birthplace:  Bohemia Aus
Occupation:  Farmer
DOD:  July 15, 1904  6pm
Cause:  Heart and Kidney disease


Dallas
Un named
Female White
May 23, 1904
Birthplace Dallas, OR
Father:  Sam Ray
Birthplace:  Missouri
Mother:  Boyd
Birthplace: Indiana
DOD:  July 23, 1904
Cause:  Unable to retain Nourshment from birth


Polk Station
Angenetta Querring
Female White
June 20, 1901
Birthplace:  Polk Station
Father:  J.W. Quering
Birthplace:  Russia
Mother:  Susie Reddekoph
Birthplace:  Alberta Canada
DOD:  Aug 1, 1904 4pm
Cause:  Arsenical Poisoning


Dallas
Catherine Shelton
Female White
Sept 6, 1820
Widow
Birthplace:  Smith Co., VA
DOD:  Aug 2, 1904 6 am
Cause:  Pulmonary obstruction


Monmouth
Essie Edna Simpson
Female White
DOB:  May 12, 1882
Single
Birthplace:  Lewisville, Polk Co., OR
Father:  Ruben H. Simpson
Birthplace:  Lewisville Polk Co. OR
Mother:  Mirum A. Herren
Birthplace:  Benton Co., OR
DOD:  Aug 4, 1904 11pm
Cause:  Pulmonary Tuberculosis
Buried:  IOOF Independence


Buena vista
William M. Cooper
Male White
age  32 years
Married
Occupation:  Logger
DOD:  Aug 8, 1904 4pm
Buried:  city View Cemetery


Dallas
un named
Male White
DOB:  Aug 7, 1904
Birthplace:  Dallas
Father:  Frank V. Brown
Birthplace:  Dallas, OR
Mother:  Mabel Myers
Birthplace:  Schuyller Co., PA
DOD:  Aug 24, 1904 3 am
Cause:  Hepatetis


Dallas
Florence Gerturde Simonton
Female White
DOB:  May 15, 1883
Single
Birthplace:  Lawrence co. PA
Father:  James Simonton
Birthplace:  Lawrence Co., PA
Mother:  Malinda Kozer
Birthplace Mifflin Co. PA
DOD:  Sept 3, 1904 6pm
Cause Cerebral Congestion


Independance
Joseph Roner
Male White
DoB 1847
Married
Birthplace:   Bohemia
Father:  Joseph Roner
Birthplace:  Bohemia
Mother:  Teressa
Birthplace:  Bohemia
Occupation:  Farmer
DOD:  Sept 6, 1904
Cause:  Accidental drowning Will River
Buried Albany, OR


Dallas
Mary E. Gibson
Female White
DOB:  Oct 25, 1839
Widowed
Birthplace Pike Co., IL
Father ???Hirans
Mother:  Mary E. Hirans
DOD:  Sept 2, 1904  7:30 am
Cause:   Uninary Suppression


Monmouth
Jessie Gross
Male White
DOB:  March 8, 1830
Married
Birtholace:  Randolph Co., MO
Father:  J.M. Gross
Birthplace:  IL
Mother:  Rachel White
Birthplace:  IN
Occupation:  Wagonmaker
DOD:  Sept 21, 1904 4am


Independence
Paloma Mae Clodfelter
Female White
DOB:  July 3, 1904
Birthplace:  Independence
Father:  Clarence Clodfelter
Birthplace:  Iowa
Mother:  Amanda Griffa
Birthplace:  Kansas
DOD:  Sept 25, 1904 3:45 am
Cause:  Cholera Infautum
Buried:  IOOF Cemetery


Independence
Henry Hill
Male White
DOB:  Jan 20, 1824
Married
Birthplace:  NY
Father:  Ladue Hill
Mother:  Eliza Aurelia Taylor
Occupation:  Farmer
DOD:  Oct 17, 1904 12
Buried:  Rickerall, OR


Falls City
Dorothea M. McGinnis
Female White
DOB:  Oct 7, 1902
Birthplace:  Falls City, OR
Father:   Wm McGinnis
Birthplace:   New Lisbon, OH
Mother:  Elma Campbell
Birthplace Muscatina, IA
DOD:  Oct 7, 1904 1:00am
Entero Colitis


Independence
Leonard Honna
Male White
DOB:  June 5, 1904
Birthplace:  Independence
Father:  James L. Honna
Birthplace:  PA
Mother:  Elsie Irvine
Birthplace:  Polk Co, OR
DOD:  Oct. 4, 1904 9pm
Buried IOOF Cemetery


3 mi NW of Salem
Hidde G. Stonebrink
Male White
DOB:  Feb 7, 1812
Widower
Birthplace:  Holland
Father:  Gerben Stonebrink
Birthplace:  Holland
Mother:  Bauwkje Fisher
Birthplace:  Holland
Occupation:  Farmer
DOD:  Oct, 9, 1904 3pm
Cause:  Senility


Independence
Grace L. Gillispie
Female White
age 7 years
Birthplace:  Monroe Co. Mich
Father:  E.B. GIllispie
Birthplace:  Birmingham, Mich
Mother:  Orilla Grace Miller
Birthplace:  Lansing, Mich
DOD:  Oct 17, 1904 11pm
Cause:  Pneumonia
Buried:  IOOF Cemetery


Independence
Harris L. Wing
Male White
Single
Birthplace:  Russia
Father:  Lewis Wing
Birthplace:  Russia
Mother:  Sivia Wing
Birthplace:  Russia
Occupation:  Farmer
DOD:  Nov 6, 1904 7:30am
Cause:  Heart
Buried Ahonia Sholom Cemetery


Dallas
Veita E. yron
Female White
DOB:  Oct 30, 1898
Birthplace:  OR
Father:  Marion Syron
Birthplace:  OR
Mother:  Mollie Stakely
Birthplace:  OR
DOD:  November 28, 1904
Cause:  Pnuemonia
Buried:  IOOF Cemetery


Ballstom
John McCollough
Male White
Father:  George Mc Collough
Birthplace:  Scotland
Mother:  Jane Holmes
Birthplace:  Scotland
Occupation:  Farmer
DOD:  Dec 9, 1904
Buried Plesant Hill Cemetery


Monmouth
Ruby  Fay Denney
Female White
DOB:  Nov 14, 1904
Birthplace:  Monmouth, OR
Father:  S.C. Denney
Birthplace:McCoy OR
Mother M.P. ???
Birthplace:  McCoy  OR
DOD:  Dec 17, 1904 2pm
Cause:  Pneumonia
Buried:  Monmouth


McCoy
Maggie E. ToziesrFemale White
DOB:  Nov 2, 1852
Married
Birthplace:  IA
Father:  Solomon Bishop
Birthplace:  KY
Mother:  Sabitha Miller
Birthplace:  OH
Informant A.R. Tozier
DOD:  Dec, 22, 1904 3am


Dallas
Charles Robert Farley
Male White
DOB July 18m 1858
Married
Birthplace:  Polk Co., OR
Father:  Robert Farley
Birthplace:  Campbell Co., TN
Mother:  Lydia Cooper
Birthplace:  Hamilton Co. OH
Occupation:  Farmer
Informant:  May Farley
DOD:  Dec 23, 1904
Cause:  Pneumonia


John A Williams
Male White
DOB:  March 7, 1865
Married
Birthplace
IN
Father:  John A. Williams
Birthplace:  IN
Mother:  Lucinda Price
Birthplace:  IN
Occupation:   Farmer
Informant:  Martha Williams
DOD:  Dec 23, 1904 4pm
Cause:  Pneumonia


Monmouth
Hennery J. Butler
Male White
DOB:  Sept 27, 1844
Birthplace:  Pitsfield, IL
Father J.B.V. Butler
Birthplace: NH
Mother:  Elizabeth Ingals
Birthplace:  Madison O.
Informant:  J. B. Butler
DOD:  Dec 25, 1904   9pm
Cause:  Organic Heart Disease


Independence
Female White
Baby Iliff
DOB:  Dec 18, 1904
Birthplace:  Independence
Father:  Charles S. Iliff
Birthplace:  Washbern, IL
Mother:  Lila Henrietta Butler
Birthplace:  Washbern, IL
DOD:  Dec 26, 1904 1:00[,
Cause:  Premature birth (7 months)


Dallas
Elizabeth May Whiteham
Female White
DOB:   May 9, 1868
Married
Birthplace:  Nebraska
Father:  David Boals
Birthplace:  PA
Mother:  Hannah J. Boyd
Birthplace:  PA
Informant:  Harvey Boals
DOD:  December 27, 1904   3am
Cause:  Pneumonia
Buried: IOOF Cemetery


Independence
E.G.Heath
Male White
DOB:  July 6, 1842
Married
Birthplace:  Pleasaant  Mills IN
Father:  George Heath
Birthplace:  IN
Mother:  Rachel Robuck Heath
Birthplace:  IN
Occupation:  Potter
DOD:  December 30, 1904 3 pm
Died suddenly and alone with his wife.
Buried:  IOOF Cemetery