USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 11
USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 11
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Other Medals and Foreign Decorations
Kind of Occupation Before War Service. Laborer
Married or Single .................
Single
If Ever Married, Maiden Name of Wife (or Wives)
Date and Place of Marriage to Wife (or Wives)
Date and Place of Death of Wife (or Wives)
If Any Divorce, Date and Place Where Granted
If Married was Your Wife Ever Married Before Married to You
If So, Name of Former Husband, and Date and Place of His Death or Divorce
Names. Ages and Places of Birth of All Children, if any ..
Name of Father and Place of Residence. Thomas a Murray (Deceased)
Name of Mother and Place of Residence. Cath. M. Murray. Canton, Mass
Are You Without the Foregoing Relatives in This Country
If So, Ilave You a Brother or Sister Here. ....... ..............
And if so, Give Full Name and Address of Either or Both
Have You a War Risk Insurance Policy.
Give Number of Policy .............. ....
What Was Your Weight When Entering the Service
148 lbs
Your Height in Feet and Inches
.....
5' 6'
Your Complexion-White or Colored White
Color of Your Eyes. Blue
Color of Your Hair Br
Give Names and Addresses of Two or Three of Your Most Intimate Comrades .. Glen N. Hardy Harvard It. Dorchester, mass Frederick Brewster, Care EMnew York
Have You a Photograph of Self, in Service Uniform, to Give Town yes
If Foregoing Record is of One Deceased, Give Date of Deatlı
Give Place of Death and Place of Burial ....
Give Burial Lot Number.
Any Monument or Headstone Marked to Deceased Where Buried
Any Memorial for Deceased in Other Cemetery Than Where Buried
If Grave is Unmarked Will Permission be Given to Set a Government Headstone.
Name and Address of Person Filling Out This Record of Deceased.
REMARKS.
(Please give here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
Thomas Henry Joseph Murray
COMPLETE NAME. NO INITIALS PLEASE WRITE PLAINLY
Name
Thomas
H. A. murray
AS APPEARS ON THE SERVICE ROLL
Date of Birth ..
3
DAY
MONTH YEAR
Place of Birth.
....
Hyde Park
mara
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service 558 Washington Canton Mass
STREET AND NUMBER CITY OR TOWN STATE
Place of Residence at Present Tim
558 Washington, Canton Mass
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted Enlisted
Date and Place of Enlistment
Feb. 23, 1917.
Boston
Date and Place Where Drafted
Date and Place Where Mustered In or Reported for Duty Feb. 23 1917 Boston
Give Government Identification Tag Number
Co., Regt., Ship, or Service, First Assigned to and Date
U. S& Patterson
Other Regiments, Ships or Branches of Services, Transferred to and Dates.
Training
Station Newport Rhode Island
Texas Hannibal Tr Sta Hingham
Rank While in Service. Capsu
If Commissioned Officer Give Date of Commission.
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Overseas
Jan
1899
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas american Navy European Dances
If so, Date and Ship from the United States or Canada
may 18'18 Hannibal
Port Sailed From for Overseas
New London Conn
Date of Arrival Overseas
Plymouth Eng
June 3 1918 .
Port of Arrival Overseas.
Date and Ship Sailed Returning Home.
Hannibal, auq 1919
Port Sailed from Returning Home
Break
Date of Arrival from Overseas.
aug 1919
Place of Arrival in United States
new york
Important Places Where Stationed Overseas.
Plymouth, Cuq.
Break france
Lisbon Portugal
Participated in What Battles and Dates of Same
Wounded or Other Injuries Received in Action, Place and Date
If Confined in Hospital. During What Time and Place
If Prisoner by Enemy, Date and Place of Capture. Places Confined
Date and Place Released
Give Record of Service in Army or Navy before the German War if Any
When Discharged from Service. Sept 11, 1919
Where Discharged from Service
Hingham masa
For What Reason Discharged from Service.
Enlistment expired
If Given Medal of Honor, Give Action and Date. ....
If Given Citation or Certificate of Merit, Give Service and Date
Other Medals and Foreign Decorations
Kind of Occupation Before War Service. Chauffeur
Married or Single Single
If Ever Married, Maiden Name of Wife (or Wives)
Date and Place of Marriage to Wife (or Wives) ...........
Date and Place of Death of Wife (or Wives) ....
If Any Divorce, Date and Place Where Granted
If Married was Your Wife Ever Married Before Married to You
If So, Name of Former Husband, and Date and Place of His Death or Divorce
Names, Ages and Places of Birth of All Children, if any
Name of Father and Place of Residence. Thomas a. Murray (Deceased)
Name of Mother and Place of Residence. Cath. Murray. Canton Mass.
Are You Without the Foregoing Relatives in This Country no
If So, Have You a Brother or Sister Here .....
And if so, Give Full Name and Address of Either or Both
Have You a War Risk Insurance Policy Give Number of Policy. ..............
...... no
What Was Your Weight When Entering the Service
128 cho
Your Height in Feet and Inches.
...........
5' 7'
Your Complexion-White or Colored White
Color of Your Eyes. Blue
Color of Your Hair Brown
Give Names and Addresses of Two or Three of Your Most Intimate Comrades
Have You a Photograph of Self, in Service Uniform, to Give Town
If Foregoing Record is of One Deceased, Give Date of Death
Give Place of Death and Place of Burial
Give Burial Lot Number.
..........
Any Monument or Headstone Marked to Deceased Where Buried
Any Memorial for Deceased in Other Cemetery Than Where Buried
If Grave is Unmarked Will Permission be Given to Set a Government Headstone.
Name and Address of Person Filling Out This Record of Deceased.
..
REMARKS. (Please give here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
Walter Ray Michale
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
Walter P. Michale
AS APPEARS ON THE SERVICE ROLL
Date of Birth 12 July
1896
DAY
MONTH
YEAR
Place of Birth.
Canton
maga
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service.
89 Venner Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time.
89 Kenney,
Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted. Enlisted
Date and Place of Enlistment
april 17, 1917
Boston
Date and Place Where Drafted.
Date and Place Where Mustered In or Reported for Duty July 25 1917
Give Government Identification Tag Number.
3563
Co., Regt., Ship, or Service, First Assigned to and Date 2nd ambulance Co.
Other Regiments, Ships or Branches of Services, Transferred to and Dates. 103rd ambulance, Co. 101st Sanitary Train.
Rank While in Service. Nagy joner
If Commissioned Officer Give Date of Commission.
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Querse
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas yes
american
If so, Date and Ship from the United States or Canada
Sept 15,17. Canada
Port Sailed From for Overseas
montreal
Date of Arrival Overseas
Oct 2 1917
Port of Arrival Overseas.
Liverpool
Date and Ship Sailed Returning Home.
apr. 6,19, Minifrediano
Port Sailed from Returning Home.
Break
Date of Arrival from Overseas.
april 18, 1919
Place of Arrival in United States
Boston
Important Places Where Stationed Overseas.
Participated in What Battles and Dates of Same arine Soissons Del Mar, 19. Tout apr. 3- June 28, 18 Chateau Thierry July 4-28, It michiel aug 19- Sept 15. Trayon Sept- Och 9 Verdun Oct g- nov 11, 1918.
Wounded or Other Injuries Received in Action, Place and Date
If Confined in Hospital, During What Time and Place
If Prisoner by Enemy, Date and Place of Capture .. .......
.........
Places Confined
Date and Place Released
Give Record of Service in Army or Navy before the German War if Any
When Discharged from Service. april 29 1919
Where Discharged from Service Camp Deveno
For What Reason Discharged from Service.
Demobilization
If Given Medal of Honor, Give Action and Date. ........ If Given Citation or Certificate of Merit, Give Service and Date Other Medals and Foreign Decorations
Kind of Occupation Before War Service.
Married or Single ............. Single
If Ever Married, Maiden Name of Wife (or Wives)
Date and Place of Marriage to Wife (or Wives)
Date and Place of Death of Wife (or Wives)
If Any Divorce, Date and Place Where Granted.
If Married was Your Wife Ever Married Before Married to You
If So, Name of Former Husband, and Date and Place of His Death or Divorce
....
Names, Ages and Places of Birth of All Children, if any
Name of Father and Place of Residence. Robert nichols. (Deceased)
Name of Mother and Place of Residence. annie Canton Maso
Are You Without the Foregoing Relatives in This Country
no.
If So, Have You a Brother or Sister Here.
And if so, Give Full Name and Address of Either or Both
Have You a War Risk Insurance Policy.
Give Number of Policy
....
What Was Your Weight When Entering the Service
13 alho
Your Height in Feet and Inches.
51 73/4"
Your Complexion-White or Colored
White
Color of Your Eyes.
........
Blue
....
Color of Your Hair Blonde
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Richard Darrow, Canton mage Frank Kendall Herbert Guild
Have You a Photograph of Self, in Service Uniform, to Give Town no
If Foregoing Record is of One Deceased, Give Date of Death
Give Place of Death and Place of Burial.
Give Burial Lot Number. ..............
Any Monument or Headstone Marked to Deceased Where Buried
Any Memorial for Deceased in Other Cemetery Than Where Buried
If Grave is Unmarked Will Permission be Given to Set a Government Headstone.
Name and Address of Person Filling Out This Record of Deceased
REMARKS. (Please give here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
George albert OBrien
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY ,
Name George albert OBrien
Date of Birth ........ ..... 18 DAY Canton
AS APPEARS ON THE SERVICE ROLL
June
1893
MONTH
YEAR
mass
Place of Birth ..
......
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service 25 ames Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time.
25
"
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted. Enlisted
Date and Place of Enlistment
July 1917
Boston
Date and Place Where Drafted
Date and Place Where Mustered In or Reported for Duty Aug. 25, 17 Boston
Give Government Identification Tag Number 772963
Co., Regt., Ship, or Service, First Assigned to and Date Quartermastero Corpo
Other Regiments, Ships or Branches of Services, Transferred to and Dates
Receiving Co.3
Rank While in Service.
Corporal Sergeant
If Commissioned Officer Give Date of Commission
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service Dr. Rodman
Jacksonville Fla. Quero
ara
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas amer can
yes
If so, Date and Ship from the United States or Canada
may 1, 1918
Port Sailed From for Overseas
New york
Date of Arrival Overseas
may
a 1918
Port of Arrival Overseas.
Break
Date and Ship Sailed Returning Home
June 25,1919
Port Sailed from Returning Home.
Brest
Date of Arrival from Overseas
July 8, 1919
Place of Arrival in United States
new york
Important Places Where Stationed Overseas
Camp de Louge,
Camp
Shannon
Participated in What Battles and Dates of Same.
Wounded or Other Injuries Received in Action, Place and Date
.....
If Confined in Hospital, During What Time and Place
If Prisoner by Enemy, Date and Place of Capture .. .........
Places Confined
Date and Place Released
Give Record of Service in Army or Navy before the German War if Any
When Discharged from Service. July 15, 1919
Where Discharged from Service
Campo Deveno
For What Reason Discharged from Service.
Demobilization
If Given Medal of Honor, Give Action and Date.
If Given Citation or Certificate of Merit, Give Service and Date
Other Medals and Foreign Decorations
Kind of Occupation Before War Service. Book keeper
Married or Single
Single
If Ever Married, Maiden Name of Wife (or Wives)
Date and Place of Marriage to Wife (or Wives)
Date and Place of Death of Wife (or Wives)
If Any Divorce, Date and Place Where Granted.
If Married was Your Wife Ever Married Before Married to You
If So, Name of Former Husband, and Date and Place of His Death or Divorce
Names. Ages and Places of Birth of All Children, if any
Name of Father and Place of Residence.
Deceased
Name of Mother and Place of Residence .. ......
Are You Without the Foregoing Relatives in This Country
yes
If So, Have You a Brother or Sister Here. Sister
And if so, Give Full Name and Address of Either or Both
mary E. anna G. mildred, ames Que
Canton, maso
Have You a War Risk Insurance Policy.
yes
Give Number of Policy.
....
What Was Your Weight When Entering the Service 158 lho
Your Height in Feet and Inches. 5' 8 '
Your Complexion-White or Colored
White
Color of Your Eyes ..
........
Gray
Color of Your Hair
Black
Give Names and Addresses of Two or Three of Your Most Intimate Comrades
Have You a Photograph of Self, in Service Uniform, to Give Town no
If Foregoing Record is of One Deceased, Give Date of Deatlı
Give Place of Death and Place of Burial
Give Burial Lot Number. .........
Any Monument or Headstone Marked to Deceased Where Buried
Any Memorial for Deceased in Other Cemetery Than Where Buried
If Grave is Unmarked Will Permission be Given to Set a Government Headstone
Name and Address of Person Filling Out This Record of Deceased
....
REMARKS. (Please give here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
John Joseph OBrien
1
Name
...
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name John J. OBrien
AS APPEARS ON THE SERVICE ROLL
October
1891
Date of Birth.
......
5
DAY
Canton
MONTH YEAR
maso
Place of Birth.
....
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Services 248 Mechanic Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time 248 Mechanic, Canton Mass
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted. Drafted
Date and Place of Enlistment
Date and Place Where Drafted Canton. Sept 20, 1917
Date and Place Where Mustered In or Reported for Duty Camp Devens, Sept. 21, 17
Give Government Identification Tag Number. .......... 1666219
Co., Regt., Ship, or Service, First Assigned to and Date
Sept 21, 1917
Co 2.
302nd. Infantry
Other Regiment=, Ships or Branches of Services, Transferred to and Dates. 2. Co. 301 st. Supply Train. Sept 28 1917
Rank While in Service.
Private Corporal, Sergeant
If Commissioned Officer Give Date of Commission.
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Camp Devino
Overseas
yes Any Service in American Expeditionary Force or Canadian or Allied Force Overseas american If so, Date and Ship from the United States or Canada July 15, 17 Winifredian
Port Sailed From for Overseas
Boston
Date of Arrival Overseas
aug. 1, 1917
Port of Arrival Overseas.
avonmouth Eng.
...
Date and Ship Sailed Returning Home
May 24'19. La Lorraine
Port Sailed from Returning Home.
Le Havre
Date of Arrival from Overseas.
June 1, 1919
Place of Arrival in United States
new york
Important Places Where Stationed Overseas.
It amand
Montrond. Cher.
Le Havre
Participated in What Battles and Dates of Same. ....
......
Wounded or Other Injuries Received in Action, Place and Date
If Confined in Hospital, During What Time and Place
If Prisoner by Enemy, Date and Place of Capture.
Places Confined
Date and Place Released
Give Record of Service in Army or Navy before the German War if Any
When Discharged from Service.
July 11 1919
Where Discharged from Service
Camp Deveno
For What Reason Discharged from Service ..
Demobilization
If Given Medal of Honor, Give Action and Date. ........ ....
....
If Given Citation or Certificate of Merit, Give Service and Date
Other Medals and Foreign Decorations
Kind of Occupation Before War Service. Painter
Married or Single Single
If Ever Married, Maiden Name of Wife (or Wives)
Date and Place of Marriage to Wife (or Wives)
Date and Place of Death of Wife (or Wives)
If Any Divorce, Date and Place Where Granted.
If Married was Your Wife Ever Married Before Married to You
If So, Name of Former Husband, and Date and Place of His Death or Divorce
Names, Ages and Places of Birth of All Children, if any
Name of Father and Place of Residence.
matthew OBrien (Deceased)
Name of Mother and Place of Residence margaret 1. .!! Are You Without the Foregoing Relatives in This Country
If So. Have You a Brother or Sister Here ..................
And if so, Give Full Name and Address of Either or Both
Have You a War Risk Insurance Policy ..... Give Number of Policy
What Was Your Weight When Entering the Service
145 lbs
Your Height in Feet and Inches.
5' 10 '
Your Complexion-White or Colored White
Color of Your Eyes.
Blue
Color of Your Hair
Braun
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Oliver Have Brockton mago Peter Murphy New Bedford. Francis Lyons, milton
Have You a Photograph of Self, in Service Uniform, to Give Town
If Foregoing Record is of One Deceased, Give Date of Death
Give Place of Death and Place of Burial
Give Burial Lot Number.
Any Monument or Headstone Marked to Deceased Where Buried Any Memorial for Deceased in Other Cemetery Than Where Buried
If Grave is Unmarked Will Permission be Given to Set a Government Headstone. Name and Address of Person Filling Out This Record of Deceased.
REMARKS. (Please give here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
Jeange William OConnell
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
George r. OConnell.
AS APPEARS ON THE SERVICE ROLL
Date of Birth ..
1
October
1893
DAY
MONTH
YEAR
Place of Birth ..
Canton
masa
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service/73
Rockland Canton, mass
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time./.7.3. Rockland, Canton, Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted.
Enlisted
Date and Place of Enlistment
april 25, 1917 Boston
Date and Place Where Drafted
Date and Place Where Mustered In or Reported for Duty apr. 25'17, It Slocum, n.Y
Give Government Identification Tag Number.
346267
Co., Regt., Ship, or Service, First Assigned to and Date
9th. C. C. a. C.
Other Regiments, Ships or Branches of Services, Transferred to and Dates.
9th. Co. Balboa
C.a.C.
Rank While in Service.
Private.
If Commissioned Officer Give Date of Commission.
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Fort Grant. Canal Gone.
Darf amador
..
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas -
If so, Date and Ship from the United States or Canada
Port Sailed From for Overseas Date of Arrival Overseas Port of Arrival Overseas.
Date and Ship Sailed Returning Home.
Port Sailed from Returning Home.
Date of Arrival from Overseas.
Place of Arrival in United States
Important Places Where Stationed Overseas.
Participated in What Battles and Dates of Same.
Wounded or Other Injuries Received in Action, Place and Date
If Confined in Hospital, During What Time and Place
If Prisoner by Enemy, Date and Place of Capture.
Places Confined
Date and Place Released ........
Give Record of Service in Army or Navy before the German War if Any
When Discharged from Service. May 23, 1919
Where Discharged from Service
Campo Deveno
For What Reason Discharged from Service.
Demobilization
If Given Medal of Honor, Give AAction and Date ........... If Given Citation or Certificate of Merit, Give Service and Date
Other Medals and Foreign Decorations
Kind of Occupation Before War Service Clerk
Married or Single Single
If Ever Married, Maiden Name of Wife (or Wives)
Date and Place of Marriage to Wife (or Wives)
Date and Place of Death of Wife (or Wives)
If Any Divorce, Date and Place Where Granted.
If Married was Your Wife Ever Married Before Married to You
If So, Name of Former Husband, and Date and Place of His Death or Divorce
Names. Ages and Places of Birth of All Children, if any
..
Name of Father and Place of Residen
William OConnell Canton
Name of Mother and Place of Residence
Ellen
Are You Without the Foregoing Relatives in This Country
no.
If So, Have You a Brother or Sister Here.
And if so, Give Full Name and Address of Either or Both
Ilave You a War Risk Insurance Policy
Give Number of Policy ....
What Was Your Weight When Entering the Service
133 lbs
Your Height in Feet and Inches.
5/8''
Your Complexion-White or Colored
White
Color of Your Eyes.
Bracon
Color of Your Hair
Dark Brown
Giye Names and Addresses of Two or Three of Your Most Intimate Comrades John Hanrahan, New york City 2.2 O'neill Lawyer ce gnass Lewis Schaeffer, Gankers n. y
Have You a Photograph of Self, in Service Uniform, to Give Town
If Foregoing Record is of One Deceased, Give Date of Deatlı
Give Place of Death and Place of Burial.
Give Burial Lot Number.
Any Monument or Headstone Marked to Deceased Where Buried
Any Memorial for Deceased in Other Cemetery Than Where Buried
If Grave is Unmarked Will Permission be Given to Set a Government Headstone.
Name and Address of Person Filling Out This Record of Deceased
REMARKS. (Please give here any matter of interest relating to Your Service.)
....
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
John H. Oneill
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
John H. Oneill
AS APPEARS ON THE SERVICE ROLL
8
DAY
Debruary
1893
Date of Birth
....
MONTH
YEAR
Canton
mase
Place of Birth
.......
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service/7 Neponset Canton Mass
STREET AND NUMBER CITY OR TOWN STATE
Place of Residence at Present Time 17 Nexanset Canton, Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted.
Drafted
Date and Place of Enlistment
Date and Place Where Drafted
Canton.
June 1, 1918
Date and Place Where Mustered In or Reported for Duty June1, 1918
Give Government Identification Tag Number. 3172004
Co., Regt., Ship, or Service, First Assigned to and Date
Co#8 Veterinary Hospital
Other Regiments, Ships or Branches of Services, Transferred to and Dates.
Rank While in Service ..
Private
/c Private
If Commissioned Officer Give Date of Commission.
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Overseas
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas american
If so, Date and Ship from the United States or Canada
July 2 6'18, Susquehanna
Port Sailed From for Overseas
Newport News
Date of Arrival Overseas
aug 5, 1918
Port of Arrival Overseas.
Break
Date and Ship Sailed Returning Home.
May 23 1919 Frederick
Port Sailed from Returning Home.
Break
Date of Arrival from Overseas.
June 2, 1919
Place of Arrival in United States
Brooklyn
Important Places Where Stationed Overseas.
Claye-
Souilley
Participated in What Battles and Dates of Same.
Wounded or Other Injuries Received in Action, Place and Date
If Confined in Hospital. During What Time and Place
If Prisoner by Enemy, Date and Place of Capture.
Places Confined
Date and Place Released
Give Record of Service in Army or Navy before the German War if Any
When Discharged from Service.
June 10, 1919
Where Discharged from Service
Camp Devers
For What Reason Discharged from Service.
Demobilization
If Given Medal of Honor, Give Aetion and Date ..
If Given Citation or Certificate of Merit, Give Service and Date
Other Medals and Foreign Decorations
Kind of Occupation Before War Service. Driver
Married or Single Single
If Ever Married, Maiden Name of Wife (or Wives)
Date and Place of Marriage to Wife (or Wives)
Date and Place of Death of Wife (or Wives)
If Any Divorce, Date and Place Where Granted.
If Married was Your Wife Ever Married Before Married to You
If So, Name of Former Husband, and Date and Place of His Death or Divorce
Names, Ages and Places of Birth of All Children, if any
Name of Father and Place of Residence
The P. Oneill Canton
Name of Mother and Place of Residence.
Cath. Oneill
Are You Without the Foregoing Relatives in This Country no.
If So, Have You a Brother or Sister Here.
And if so, Give Full Name and Address of Either or Both
Have You a War Risk Insurance Policy.
Give Number of Policy.
What Was Your Weight When Entering the Service 147 lbs
Your Height in Feet and Inehes.
.........
5 ' 11'
Your Complexion-White or Colored White
Color of Your Eyes.
Bracon
Color of Your Hair
Brown
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Jahr Hurley Stoughton mass
Clarence
Ilave You a Photograph of Self, in Service Uniform, to Give Town ono
If Foregoing Record is of One Deceased, Give Date of Death
Give Place of Death and Place of Burial.
Give Burial Lot Number.
Any Monument or Headstone Marked to Deceased Where Buried
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