World War records : Canton, Massachusetts, 1917-1918, Part 15

Author: Canton (Mass.). Town Clerk
Publication date: 1917
Publisher: The Town
Number of Pages: 634


USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 15
USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 15


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service


Any Service in American Expeditionary Force or Cinadian or Allied Force Overseas Ofes


american


If so, Date and Ship from the United States or Canada


Pastorie


Port Sailed From for Overseas


Hoboken


Date of Arrival Overseas


Sept 21 1917


Port of Arrival Overseas.


It nazaire


Date and Ship Sailed Returning Home


Deb. 61919, matsonia


Port Sailed from Returning Home


Bordeaux


Date of Arrival from Overseas


Deb 15, 1919


Place of Arrival in United States


Hoboken


Important Places Where Stationed Overseas.


Neufchateau


Touro.


Blais


Participated in What Battles and Dates of Same.


Chemin-de-dames


Deb. 21. Tout June 20. Chateau Thierry,


July 17, St Michiel Oct 25.


Wounded or Other Injuries Received in Action, Place and Date


Gassed-


Chateau Thierry July 18. Tout Sector


two machine gun bullets, June 25.


If Confined in Hospital, During What Time and Place


Base #43, Blais


July august, Sept


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 mexican Border Service June 1916- Nov. 1916.


When Discharged from Service.


march 15, 1919


Where Discharged from Service


Camp Deveno mago


For What Reason Discharged from Service


Disabled


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 .. Cutter


Married or Single Lungle


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.


Peter & Robertson, Canton


Name of Mother and Place of Residence.


Cath


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.


1645032


What Was Your Weight When Entering the Service


155 lbs.


Your Height in Feet and Inches.


5/ 11/2"


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 Jahr Haman, Dorchester maxx Frank martin, Somerville Frank Sullivan Charlestown"


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


Dana R. Robie


COMPLETE NAME.


NO INITIALS. PLEASE WRITE PLAINLY


Name Dona.


R. Rafie


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


.......


6


may


1895.


DAY


MONTH YEAR


amesbury


masa


Place of Birth ..


.....


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service 729 Wach. Canton Mars.


STREET AND NUMBER .


CITY OR TOWN STATE


Place of Residence at Present Time 16 Endicott Cantow, Mass.


STREET AND NUMBER CITY OR TOWN STATE


Enlisted or Drafted.


Enlisted


Date and Place of Enlistment Taunton, Nov 30, 1917


Date and Place Where Drafted


Date and Place Where Mustered In or Reported for Duty Dec 7. 1917.


Give Government Identification Tag Number. 2489215


Co., Regt., Ship, or Service. First Assignel to and Date 2nd Div. aviation Squadron 27 Other Regiments, Ships or Branches of Services, Transferred to and Dates 833 Squad


Field #2, Gen. Supply Concen. Camp


Rank While in Service.


Private Corporal


If Commissioned Officer Give Date of Commission.


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service Naco Texas


Hempstead L.l.


Any Service in American Expeditionary Force or Canadian or Allied Force Overseas american


If so, Date and Ship from the United States or Canada


may 11,12 Quelem


Port Sailed From for Overseas


Liverpool


Date of Arrival Overseas


may 22, 18


Port of Arrival Overseas.


Liverpool


Date and Ship Sailed Returning Home.


nov 23 1918


Port Sailed from Returning Home


Liverpool


Date of Arrival from Overseas


Dec 4 1918


Place of Arrival in United States


New york


Important Places Where Stationed Overseas.


Grantham Winchester


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.


Dec 14, 1918


Where Discharged from Service


Camp mille L.S


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. Railroad Fireman


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.


Raymond Robie, Canton


Name of Mother and Place of Residence


Justine Robie


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.


ono.


Give Number of Policy


What Was Your Weight When Entering the Service 150 lbs


Your Height in Feet and Inches.


......


5/7'


Your Complexion-White or Colored


white


Color of Your Eyes.


......


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


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


Norman Leander Robinson


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


norman


Leander Polucon


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


9


October


1896


DAY


MONTH


YEAR


nova


Scotia.


Place of Birth.


annapolis


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service.


6 Waverly Roxbury Mare


STREET AND NUMBER


CITY'OR TOWN


STATE


Place of Residence at Present Time 580 Main, Rutland, Oregon


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment.


Date and Place Where Drafted.


June 5, 17, Canton mass


Date and Place Where Mustered In or Reported for Duty Canton nov 2017


Give Government Identification Tag Number.


....


1676147


Co., Regt., Ship, or Service, First AAssigned to and Date


29th Co. 15, Depot Brig. 20th Nov. 1917.


Other Regiments, Ships or Branches of Services, Transferred to and Dates.


Rank While in Service.


Cook


If Commissioned Officer Give Date of Commission.


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service


Camp Deveno


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.


Dec 5,1918


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. Trope business


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.


Edward Polencon nova Scotia


Name of Mother and Place of Residence.


Harriet


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


James a. Robinson


5408n. Sawyer ave, Chicago, All. Frank Robinson Chicago Il


Have You a War Risk Insurance Policy. Give Number of Policy.


What Was Your Weight When Entering the Service


130 lbs.


Your Height in Feet and Inches.


5/ 5/2''


Your Complexion-White or Colored


White


Color of Your Eyes ..


Brown


Color of Your Hair


Dark brown


Give Names and Addresses of Two or Three of Your Most Intimate Comrades Joseph H Wilcock Barry masa Walter Hermes, Troy n.4


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


Edward Joseph Rockett


COMPLETE NAME


NO INITIALS.


PLEASE WRITE PLAINLY


Name


Edward . Rockett


......


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


6


Janu


.......


1891


DAY


MONTH


YEAR


Ireland


Place of Birth


Tram


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service.


96 Bolivar Canton Mass


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time.


96 Bolivar Canton maso


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment


Date and Place Where Drafted


august 30, 1918


Date and Place Where Mustered In or Reported for Duty aug. 30, 1918


Give Government Identification Tag Number


Co., Regt., Ship, or Service, First Assigned to and Date


yth. Co. 2nd. Batt.


152 nd. Depot Brig.


Other Regiments, Ships or Branches of Services, Transferred to and Dates Headquarters Co. Sept 21,1918.


2 et Cd. 42nd. Auf. Och 4, 1918


Rank While in Service. vate


If Commissioned Officer Give Date of Commission.


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service


Camp Upton n. 4


Any Service in American Expeditionary Force or Canadian or Allied Foree 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.


Where Discharged from Service ....


For What Reason Discharged from Service. .... ....


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. Steam fitter


Married or Single married


If Ever Married, Maiden Name of Wife (or Wives) Cath, E Regan


Date and Place of Marriage to Wife (or Wives)


Nov 20'19, Canton


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 James Rockett Waterford Ire.


Name of Mother and Place of Residence ..


11


",


Are You Without the Foregoing Relatives in This Country


If So. Have You a Brother or Sister Here.


Yes


And if so. Give Full Name and Address of Either or Both


Nellie Rockett 39 Thomas Park, S. Boston.


Have You a War Risk Insurance Policy


no.


Give Number of Policy.


What Was Your Weight When Entering the Service


175 lbs.


Your Height in Feet and Inches.


5/ 10/2"


Your Complexion-White or Colored


White


Color of Your Eyes.


........


Blue


Color of Your Hair


Light


Give Names and Addresses of Two or Three of Your Most Intimate Comrades Francis Mc Dermott Canton maso James Cleary


Have You a Photograph of Self, in Service Uniform, to Give Town yes


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


James


Edward Rogers


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINL


Name James Edward Rogers


AS APPEARS ON THE SERVICE ROLL February .... :1893


Date of Birth


24


DAY


MONTH


YEAR


Place of Birth.


Canton


masa


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service. 68 Pand Canton Mars


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time ..


68 Land, Canton Mass


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted.


Enlisted


Date and Place of Enlistment


Boston,


Jan 27, 1918


Date and Place Where Drafted


Date and Place Where Mustered In or Reported for Duty Boston, Jan 30, 1918


Give Government Identification Tag Number. 1115549


Co., Regt., Ship, or Service, First Assigned to and Date


Ist Training Brig.


Other Regiment-, Ships or Branches of Services, Transferred to and Dates.


7th. Co. a. S. S. C. U. I air Service


Rank While in Service.


Corporal


If Commissioned Officer Give Date of Commission. ....


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service


Kelley Field, Texas.


Camp Sevier.


J.O


Quera


cas


Any Service in American Expeditionary Force or Canadian or Allied Force Overseas american


If so, Date and Ship from the United States or Canada


June 24, 1918


Port Sailed From for Overseas


New york


Date of Arrival Overseas


July J, 1918


Port of Arrival Overseas.


Southampton


Date and Ship Sailed Returning Home.


Dec 12 1918


Port Sailed from Returning Home.


Date of Arrival from Overseas.


Dec 30 1918


Place of Arrival in United States


Important Places Where Stationed Overseas.


Break


Dover.


..


Marake by Sea


Eng


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. Jan 23, 1919


Where Discharged from Service


Camp mills, n. 4.


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.


Paper worker


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.


anthony Rogers (Deceased)


Name of Mother and Place of Residence


mary


"1


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


Belle Rogers, 68 Pond, Canton Mass


Ilave You a War Risk Insurance Policy.


no.


Give Number of Policy


What Was Your Weight When Entering the Service


160 lbs .


Your Height in Feet and Inches.


5/ 11/2"


Your Complexion-White or Colored


Color of Your Eyes.


Brown


Color of Your Hair


Black


Give Names and Addresses of Two or Three of Your Most Intimate Comrades Ralph Deady Clark St. .. Jahre Gorman Smith Hill Prov PO


Thomas ahearn, E Walpole mass


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 liere any matter of interest relating to Your Service. )


GERMAN WAR SERVICE RECORD of Canton, Mass.


Name


Stanislaw Roman


anski


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


ist


December


Decem


893


Place of Birth. .... ....


Meracz


Poland


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service 54 Rockland St. Canton Mars.


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time.


, Pierce Place


Canton. Mass.


STREET AND NUMBER


GITY OR TOWN


STATE


Enlisted or Drafted


Enlisted


Date and Place of Enlistment


abril 2 1918


Date and Place Where Drafted


Date and Place Where Mustered In or Reported for Duty


y Stingham Press. april 2.1918


Give Government Identification Tag Number.


Co., Regt., Ship, or Service, First Assigned to and Date


Other Regiment-, Ships or Branches of Services, Transferred to and Dates.


Rank While in Service.


Second class seaman-First Third class confertips


If Commissioned Officer Give Date of Commission.


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service


Stringhan-Wakefield


Pumpkin Island - Provincetown Boston section


DAY


MONTH YEAR


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. Where Discharged from Service For What Reason Discharged from Service. ....... .


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.


Peter Romanosbei : Poland


Name of Mother and Place of Residence ..


Katherine


..


Are You Without the Foregoing Relatives in This Country


yes


If So, Have You a Brother or Sister Here


lista


And if so, Give Full Name and Address of Either or Both


anastasia Romanonabi


Have You a War Risk Insurance Policy.


no


Give Number of Policy.


What Was Your Weight When Entering the Service


Your Height in Feet and Inches.


Your Complexion-White or Colored


White


Color of Your Eyes.


Light blue


Color of Your Hair


1 Bland


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 1jea If Foregoing Record is of One Deceased, Give Date of Deathi


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 Fe 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


Samuel Rosenblatt


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


Samuel


Rosenblatt


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


16


may


1887


DAY


MONTH


YEAR


Place of Birth


Boston


maga


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service 16 Sancola, Canton Mass.


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time.


16 Lincoln Canton mass.


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment Canton Nov 11, 1918


Date and Place Where Drafted


Date and Place Where Mustered In or Reported for Duty Camp Deveno, nov 11,1918.


Give Government Identification Tag Number.


4196525


Co., Regt., Ship. or Service, First Assigned to and Date Depot Brig. 19th. Co. 5th. Batt.


Other Regiments, Ships or Branches of Services, Transferred to and Dates. Dec 4, 1918. 3rd. O. 1st. Batt. 151 st. Depat Brig.


Rank While in Service


Corporal


If Commissioned Officer Give Date of Commission.


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service


Camp Devers Mass


..


Any Service in American Expeditionary Force or Canadian or AAllied 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.


Debe 6,1919


Where Discharged from Service


Camp Deveno mass


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.


Rubber manufacturing


Married or Single


married


If Ever Married, Maiden Name of Wife (or Wives)


Sophia Liberman


Date and Place of Marriage to Wife (or Wives).


Jan 14, 1910


Boston


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


no.


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


..


Harry, Oct 14, 1910, Boston, mase




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