USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 17
USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 17
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 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. 19. 1918
Where Discharged from Service
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. motor man
Married or Single married
If Ever Married, Maiden Name of Wife (or Wives) mande Grafton
Date and Place of Marriage to Wife (or Wives) Canton. april 30, 1919
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
Name of Father and Place of Residence.
andrew Seaman, Pugwash, n.S.
Name of Mother and Place of Residence marga garet ",
Are You Without the Foregoing Relatives in This Country
If So, Have You a Brother or Sister Here.
4
And if so, Give Full Name and Address of Either or Both
James
Seaman 7 Depot, Fitchburg Mass
Have You a War Risk Insurance Policy
no.
Give Number of Policy.
What Was Your Weight When Entering the Service 137 lbs.
Your Height in Feet and Inches
...... 51 6 1/4"
Your Complexion-White or Colored white
Color of Your Eyes ..
Bacon
Color of Your Hair
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.
Semer
Name nochem COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
.......
AS APPEARS ON THE SERVICE ROLL
Date of Birth
23
aug.
1893
DAY
MONTH
YEAR
Place of Birth
Big
Kunnea
Russia
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service.
58 Talman Canton Mass.
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time ...
73 ave "O" new york, ny.
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted. Drafted
Date and Place of Enlistment
Date and Place Where Drafted
Canton Mage
Date and Place Where Mustered In or Reported for Duty
Sept 6, 1918
Give Government Identification Tag Number.
4903792
Co., Regt., Ship, or Service, First Assigned to and Date
103 Co.25 Recruit Batt.
Other Regiments, Ships or Branches of Services, Transferred to and Dates.
Camp Hancock, Ga., Oct 27
Sheffield, ala. Ordnance Dept. Nov1,
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
Syracuse n.4
- Sheffield, ala
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. march 26, 1919
Where Discharged from Service
muscle Shoals ala
...
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.
morduch Semer Russi.
Name of Mother and Place of Residence.
anna
Are You Without the Foregoing Relatives in This Country
yes
If So. Have You a Brother or Sister Here.
Eyes
And if so, Give Full Name and Address of Either or Both
may. Semer. Benny Semer ...... 18 Second auburn marie
Have You a War Risk Insurance Policy.
Give Number of Policy.
What Was Your Weight When Entering the Service 138 lbo.
Your Height in Feet and Inches. 5'2'
Your Complexion-White or Colored
Dark
Color of Your Eyes.
Braun
Color of Your Hair
Black
Give Names and Addresses of Two or Three of Your Most Intimate Comrades P. Gordon Canton masa
max Meyers, Boston
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 John George
Shaw
COMPLETE NAME. NOGNITIALS. PLEASE WRITE PLAINLY
Name John George AS APPEARS ON THE SERVICE ROLL
Shaw
Date of Birth.
.29
april
1889
DAY
MONTH
YEAR
England
Place of Birth
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service. .614 Chapman, Carton, Mass STREET AND NUMBER CITY OR TOWN STATE
Place of Residence at Present Time.
Decrase.
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted.
Enlisted
Date and Place of Enlistment.
Canada
Date and Place Where Drafted
Date and Place Where Mustered In or Reported for Duty
Give Government Identification Tag Number.
Co., Regt., Ship, or Service, First Assigned to and Date D. C. 41st Batt. C. 6. 2.
Other Regiments, Ships or Branches of Services, Transferred to and Dates
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 Mag ara -ou- Lake Overseas
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas Canadian
If so, Date and Ship from the United States or Canada
Port Sailed From for Overseas
Quebec
Date of Arrival Overseas
Port of Arrival Overseas.
Plymouth Eng
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 1.
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
George n. Shaw England
Name of Mother and Place of Residence
Betsey
........
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
Your Height in Feet and Inches.
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 June 13,16 Reported missing Give Place of Death and Place of Burial Upres - Lille-beck
Give Burial Lot Number. no.
Any Monument or Headstone Marked to Deceased Where Buried
no
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.) Left Dover, Eng. for France May 5, 1916.
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
Russell Westcott
Shaw
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
AS APPEARS ON THE SERVICE ROLL
Date of Birth
28
august
1892
DAY
MONTH
YEAR
Place of Birth
Central Grave Digly on.
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service.
39 Nach, Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time.
Sharon.
mass.
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted.
Drafted
Date and Place of Enlistment.
Date and Place Where Drafted.
Canton Oct 5, 1917.
Date and Place Where Mustered In or Reported for Duty
Och 8, 1917
Give Government Identification Tag Number
1922751
Co., Regt., Ship, or Service, First Assigned to and Date Co.A. 302 Auf. Depot Brig.
Other Regiments, Ships or Branches of Services, Transferred to and Dates. 3 th Co. Jet Training Batt, 157 Depot Brig
Co. C. 514 Engineers.
Service Batt
,
Rank While in Service.
Private Sergeant
If Commissioned Officer Give Date of Commission
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Camps Deveno Mass
Camp Gordon Ga.
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas ameri can
yes
If so, Date and Ship from the United States or Canada
Port Sailed From for Overseas
newport news, Va.
Date of Arrival Overseas
may 13, 1918
Port of Arrival Overseas.
Bordeaux
Date and Ship Sailed Returning Home.
May 13, 1917 Von Steuben
Port Sailed from Returning Home.
Brest
Date of Arrival from Overseas.
June 6, 1917
Place of Arrival in United States
Hoboken
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 Challan France July 6, 18, Camp Gordon Dec. 19, 1917.
.... 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 28, 1919
Where Discharged from Service
Campo Deveno
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. milk Dealer
Married or Single
married
If Ever Married, Maiden Name of Wife (or Wives)
Beatrice andrews
Date and Place of Marriage to Wife (or Wives) Shar mass
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
John A. Shaw nova Scotia
Name of Mother and Place of Residence ..
Effic Westcott
11
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
ITave You a War Risk Insurance Policy.
Give Number of Policy
What Was Your Weight When Entering the Service
154 lho.
Your Height in Feet and Inches
5/ 8 1/4"
Your Complexion-White or Colored
Light
Color of Your Eyes.
Blue
Color of Your Hair
Bland
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Fred Pallen new york andrew Brocheau New Hartford, Conn. Laurence Stilsan Brockton 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 here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
John Francia
Shea
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
John Francis
Shea
AS APPEARS ON THE SERVICE ROLL
September
1892
. .
Date of Birth.
26
DAY
MONTH
YEAR
Place of Birth.
..............
Elmira
n.4
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service 19
Crane
Canton, masa
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time /12/2 North
Salem mass
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted.
Drafted
Date and Place of Enlistment
Date and Place Where Drafted
Oct 4, 1917.
Salem, mass
Date and Place Where Mustered In or Reported for Duty
Oct 4, Camp Devenue
Give Government Identification Tag Number.
1675878
Co., Regt., Ship, or Service, First Assigned to and Date
17 th. Co. 5th Bu. Depot
Brig Camp Devens Oct 4, 1917.
Other Regiments, Ships or Branches of Services, Transferred to and Dates. medical Detach June 7,1918 Camp Devena mass
Rank While in Service ..
Private.
La't med. Det.
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 mass
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas 2
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. July 19 1919
Where Discharged from Service Camp Devens, 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.
manager Grocery Store
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.
Dan D. Shea Mitth, So Boston
Name of Mother and Place of Residence.
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.
no
Give Number of Policy ....
What Was Your Weight When Entering the Service
51 6'
126 lbs
Your Height in Feet and Inches.
Your Complexion-White or Colored
white
Color of Your Eyes.
Blue
Color of Your Hair
Light Brown
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Joseph Kelley, Litchfield, Conn George alquim, Hardy, Salem mass Thomas OBrien Greenfield 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 here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
David William Sheehan
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
David Williams
Sheehan
AS APPEARS ON THE SERVICE ROLL
Date of Birth.
.....
25
march
1891
DAY
MONTH
YEAR
Place of Birth
Brockton
mare
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service 479 Wach. Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time .:
479 Wash Canton Mars
STREET AND NUMBER
E
CITY OR TOWN
STATE
Enlisted or Drafted.
Drafted
Date and Place of Enlistment.
Date and Place Where Drafted
Canton. april 27, 1918
Date and Place Where Mustered In or Reported for Duty apr. 27. Camp Devene
Give Government Identification Tag Number. 1692597
Co., Regt., Ship, or Service, First Assigned to and Datec
24th. Depot Brigade
Other Regiments, Ships or Branches of Services, Transferred to and Dates.
304th. Jul, Co B. Special Duty. army School
of the Line
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
Queraças
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas American
If so, Date and Ship from the United States of Canada Salthybius July 8/8
Port Sailed From for Overseas
Charlestown
Date of Arrival Overseas
July 23, 1918
Port of Arrival Overseas.
Southampton
Date and Ship Sailed Returning Home
march 3,'19 Mt Vernon
Port Sailed from Returning Home.
Brest
Date of Arrival from Overseas.
march 11, '19
Place of Arrival in United States
new york
Important Places Where Stationed Overseas.
Langres
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. april 5- 1919
Where Discharged from Service
Camp Divers
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. 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 Residence.
David Sheehan (Deceased)
Name of Mother and Place of Residence
Hannah
Canton
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 Botlı
Have You a War Risk Insurance Policy.
no
Give Number of Policy.
What Was Your Weight When Entering the Service
164 lbs
Your Heiglit in Feet and Inclies.
5/11'
Your Complexion-White or Colored
White
Color of Your Eyes.
Blue
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 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
William
вашицен.
Shorter
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name
William
8 Shorter
AS APPEARS ON THE SERVICE ROLL
Date of Birth.
27
January
1886
DAY
MONTH
YEAR
Place of Birth.
Skipton yorkshire England
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service 27/ Walpole, Canton Mare
STREET AND NUMBER CITY OR TOWN STATE
Place of Residence at Present Time. 27/ Walpole, Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Enlisted or Drafted.
Enlisted
Date and Place of Enlistment.
Boston
June 8, 1917
Date and Place Where Drafted.
Date and Place Where Mustered In or Reported for Duty
June 8, 1917
Give Government Identification Tag Number. 1027
Co., Regt., Ship, or Service, First Assigned to and Date
Co B. Mc Lean Vilties 236th Batt
Other Regiments, Ships or Branches of Services, Transferred to and Dates.
13 the Canadian Railway Troops
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
Queralas
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas Imperial Territoriales
yes
If so, Date and Ship from the United States or Canada
Port Sailed From for Overseas
montreal.
Date of Arrival Overseas
Nov 28, 1917
Port of Arrival Overseas.
Liverpool
Date and Ship Sailed Returning Home.
metagamia apr. 23, 1919
Port Sailed from Returning Home
Liverpool
Date of Arrival from Overseas.
may 3, 1919
Quebec
Place of Arrival in United States
Important Places Where Stationed Overseas.
Seaford, Purfleet
Liverpool, Boston- 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
7th. Can. Gen. Hoop.
Etaples France, aug 3, 1918
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 3, 1919
Where Discharged from Service
quebec
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 + Decorater
Married or Single ..............
Married
If Ever Married, Maiden Name of Wife (or Wives) nellie Dael
Date and Place of Marriage to Wife (or Wives) Mar: 23' 18. Slough Bucks Eng.
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
....
Name of Father and Place of Residence.
arthur Shorter Yorkshire, Eng
La Name of Mother and Place of Residence Emily
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.
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