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Vital records and other important documents in the life of Peder Andersen (1834 - 1933)

A Collection of Vital records and other important documents in the life of Peder Andersen.

Table of Contents

1 Table of Contents
2 Vital Records Documents
2a Certified Birth Extraction
2b Utah Death Certificate
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Vital Records Documents


Table of Contents

Certified Birth Extraction


Birth Certificate for Peder Andersen

Fødsels- og dåbsattest

Birth and baptism certificate

for

for

Slægtsnavn:A n d e r s e n.

Family name: A n d e r s e n.

Fornavne: Peder.

First name: Peder.

Fødested (på landet: by,sogn, herred og amt: i købstæder: købstaden og sognet): Gabs i Avlum sogn, hammerum herred, Ringkøbing amt.
Birthplace (at,parish, judicial district and county: in købstæder: burroughs and parishes Gabs in Avlum parish, Hammerum judicial district, Ringkøbing county
Fødeslsår og -dag: 1834 - 18. september.
Birthyear and -day: 18 September 1834
Kirken, hvori barnet er døbt eller fremstillet efter hjemmedåb: Avlum kirke.
The child at the font is baptized or else performed after baptism at home Avlum church
Dåbsår ot dåbsdag samt - hvis barnet er hjemme-døbt - år og dag for fremstillingen i kirken: 1834 - 21. september.
Christening year and christening day plus - whose child is home baptized - year and day for performing in church: 21 September 1934
Forældrenes eller adoptiv-forældrenes stilling og fulde navne: Husmand Anders Nielsen og hustru Inger Jacobsdatter.
Parents or else adoptive-parents occupation and complete name Small farmer Anders Nielsen and wife Inger Jacobsdatter
Anmærkning angående op-tagelse i eller udtrædelse af folkekirken:
Note regarding inclusion in or secession by church people:

Overensstemmelsen med ministerialbogen bevidnes

agreement with the ministerial book certified

Stamp: Avlum-Hodsager Pastorat End of Stamp                on document:Avlum, den 10. juli 1967.

Stamp: Avlum-Hodsager Pastorat End of Stamp                on document: Avlum, the 10 July 1967.

Signature: Niels Pedersen

Signature: Niels Pedersen

Præstens navn.

Priest's name

Embedastempei eller segl.

Official stamp or seal

Nr. 56 A. A/S Oraf O. Barfod & Co. førlag.

No. 56 A. A/S Olaf O. Barfod & co. Publisher






Table of Contents

Utah Death Certificate


Death Certificate for Peder Andersen

State Board of Health File No. 33

STATE OF UTAH -- DEATH CERTIFICATE

1   Place of death

County Weber

Precinct

Village

City Bird Creek No. 3660 Wash. St. 1 Ward {[If death occurred in a hospital or institution give its NAME instead of address and number.]/p>

2   FULL Name Peter Anderson

    (a) Residence. No. ______________ St., _______

        (USUAL PLACE OF ABODE)                 (IF NON-RESIDENT GIVE CITY OR TOWN AND STATE)

Length of residence in city or town where death occurred 2 yrs.     mos.     ds.     How long in U. S. if of foreign birth 68 yrs.     mos.     ds.

PERSONAL AND STATISTICAL PARTICULARS

3   SEX Male   |   4   COLOR OR RACE White   |   5   SINGLE MARRIED, WIDOWED, OR DIVORCED (Write the word) Widowed

5a   If Married, Widowed or Divorced, HUSBAND OF (or) WIFE OF Larsina Tinsgaard

6   DATE OF BIRTH      September 18, 1834

                                     (Month)   (Day)   (Year)

7   AGE 98 yrs. 4 mos. 0 ds. | If LESS than 1 day, __hrs. or __mins?

8   OCCUPATION OF DECEASED

    (a) Trade, profession or particular kind of work _____

    (b) General nature of industry, business, or establishment in which employed (or employer) Farmer

    (c) Name of Employer ______

9   BIRTHPLACE   (City or town) Denmark

        (State or Country) ________

PARENTS

10   NAME OF FATHER Anders Peterson                     Note: birth certificate has last name as Nielsen

11   BIRTHPLACE OF FATHER (State or Country) Denmark

12   NAME OF MOTHER Inger Jacobsen

13   BIRTHPLACE OF MOTHER (State or Country) Denmark

14   Informant   Julia A. Curtis

        Address   2659 Granite Aco

15   Filed June 9 1933         Martha Potter

                                                  Registrar

MEDICAL CERTIFICATE OF DEATH

16   DATE OF DEATH   Jan. 18 19 33

                                     (Month)   (Day)   (Year)

17   I HEREBY CERTIFY, That I attended decreased from Dec. 26, 1931, to Jan. 15, 1932, that I last saw him alive on Jan 15, 1932, and that death occurred on the date stated above at 4:30 am.

The CAUSE OF DEATH was as follows:Have not seen him since that time. Death was apparently to general debility.

____________(Duration) ___ yrs ___ mos ___ ds.

Contributory ________________

          (Secondary)

____________(Duration) ___ yrs ___ mos ___ ds.

18   Where was disease contracted

        If not at place of death? ----

Did an operation precede death? no Date of ----

Was there an autopsy? no

What test confirmed diagnosis? _________

(Signed)Wm M. McKay, M. D.

Jan 18, 1933 (Address) Ogden, Utah

List the DISEASE CAUSING DEATH, or, in deaths from VIOLENT CAUSES state (1) MEANS AND NATURE OF INJURY: and (2) whether ACCIDENTAL, SUICIDAL OR HOMICIDAL. (See reverse side for additional space.)

19   PLACE OF BURIAL, CREMATION, OR REMOVALHuntsville Cem | DATE OF BURIAL Jan. 20, 1933

20   UNDERTAKER Lindquist & Sons | ADDRESS Ogden, Ut

READ CAREFULLY INSTRUCTIONS ON BACK OF CERTIFICATE

State of Utah     )

County of Salt Lake)

The foregoing is a true and correct copy of the original certificate on file in the Utah State Department of Health

Date June 30, 1967 Signature: John W. Wright

Director, Division of Vital Statistics