USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 21
USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 21
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Your Complexion-White or Colored
Color of Your Eyes .. ....... ......
Blue
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 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 William northend Tenney
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name William n. Tenney AS APPEARS ON THE SERVICE ROLL
Date of Birth.
....
17
Чертания.
1869
DAY MONTH YEAR
Place of Birth.
Georgetown
CITY ØR TOWN
STATE OR COUNTRY
mass
Place of Residence When Entering the Service. 756 Wash, Canton Maso
STREET AND NUMBER CITY OR TOWN STATE
Place of Residence at Present Time .. ' 756 Wask. Canton Mass
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted Drafted
Date and Place of Enlistment
Date and Place Where Drafted Com, Officer, aug 5, 1917
Date and Place Where Mustered In or Reported for Duty July 31, 1917
Give Government Identification Tag Number.
Co., Regt., Ship, or Service, First Assigned to and Date Com. Off. mar 27,17 2. Hosp. $1. 101 st Duild Hoop
Other Regiment, Ships or Branches of Services, Transferred to and Dates. last. Corps Surg. 1st army Corps. Feb 1918. Regt Sung 2nd Eng. Sept 1918. Quiero Nov.'18. Break July 3' 19.
Rank While in Service. major
If Commissioned Officer Give Date of Commission. march 27, 1917
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Querser
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas american
yes
If so, Date and Ship from the United States or Canada Hewy mallory, Sept 7, 1917
Port Sailed From for Overseas
Hoboken
Date of Arrival Overseas
Sept 21, 1917
Port of Arrival Overseas
St nazaire
Date and Ship Sailed Returning Home.
Qua 319 Imperator
Port Sailed from Returning Home.
Brest
Date of Arrival from Overseas.
aug 10, 1919
Place of Arrival in United States
Hoboken
Important Places Where Stationed Overseas.
It Nazaire, Bazvilles Meuse
Liffal-le-Grand, Langues- neufchateau,
Chateau Thierry- Villeneaux, Ardennes St malo
Participated in What Battles and Dates of Same. 2nd marne - Chateau Thierry July-aug, 1918 Ir mihiel. Sept 1917.
Champagne
Sept- Och 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 Nat Guard, magg, 1889-90 1909-1917.
When Discharged from Service august 26. 1919
Where Discharged from Service
Camp Dix
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 Deeorations
Kind of Occupation Before War Service Physician
Married or Single
married
If Ever Married, Maiden Name of Wife (or Wives)
Grace L. Holmes
Date and Place of Marriage to Wife (or Wives)
aug 12 '96 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
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
..
Constance Canton. apr. 28'98. Marian,
Canton Nov 12'02. Rosamond Canton, apr 14,05
Charles N Tenney, Georgetown, Mass.
Name of Father and Place of Residence.
Sarah
Name of Mother and Place of Residence.
Are You Without the Foregoing Relatives in This Country
(Deceased)
If So, Have You a Brother or Sister Here.
yes
And if so, Give Full Name and Address of Either or Both
Dred Tenny Winthrop mars
Have You a War Risk Insurance Policy.
yes
Give Number of Policy.
1,551676
What Was Your Weight When Entering the Service
13.8 lbs
Your Height in Feet and Inches.
5'6'
Your Complexion-White or Colored
White
Color of Your Eyes.
.....
Blue
Color of Your Hair
Dark
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Robert S. Manda. U. S army .....
James & Hall .. J. C. Hardwick, M. D. Quincy 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 Decease 1.
REMARKS. (Please give here any matter of interest relating to Your Service. )
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name Arthur Wendell Thomas
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name arthur N. Thomas
AS APPEARS ON THE SERVICE ROLL
Date of Birth ..
2
march
1897
DAY
MONTH
YEAR
Canton
mage
Place of Birth.
....
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service. 96 Prospect Canton Mass
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time.
Deceased
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted. Enlisted
Nov 1914
Date and Place of Enlistment
Re-Enlisted
1917.
Date and Place Where Drafted ......
Date and Place Where Mustered In or Reported for Duty Mar. 25,17 Camp mc Guinness
Give Government Identification Tag Number. 63102
Co., Regt .. Ship, or Service, First Assigned to and Date 101st Ind.
26th. Div mar 25.1917
Other Regiments, Ships or Branches of Services, Transferred to and Dates Supply Co. 101 st Ind
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
Querendo
...
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas
yes
ameri can
If so, Date and Ship from the United States or Canada Sept 8, 17 adriatic
Port Sailed From for Overseas
New york
Date of Arrival Overseas
Sept 1917
Port of Arrival Overseas. Liverpool
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 .. Rubenville, Chesney, Meu-le-Tout
Participated in What Battles and Dates of Same. Chemin des Dames Feb 1918. Tout apr, 1918. Chateau Thierry July 1918. Verdun Oct 1 918 argonne
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
mainar Quand mexico 1916
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. Leather 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
Thomas 8. Thomas.
Canton
Name of Mother and Place of Residence many 11 (Deceased)
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
155 lho .
Your Height in Feet and Inches.
516'
Your Complexion-White or Colored
White
Color of Your Eyes. ....
Brown
......
Color of Your Hair
Give Names and Addresses of Two or Three of Your Most Intimate Comrades If n Brown Cohasset Mare
Richard Butter So Boston
Ilave You a Photograph of Self, in Service Uniform, to Give Town
If Foregoing Record is of One Deceased, Give Date of Death Dec 22 1918
Give Place of Death and Place of Burial. La Bourboule France Give Burial Lot Number. .....
Any Monument or Headstone Marked to Deceased Where Buried
Any Memorial for Deceased in Other Cemetery Than Where Buried Flag in Canton Cemetery
If Grave is Unmarked Will Permission le Given to Set a Government Headstone.
Name and Address of Person Filling Out This Record of Deceased. George E Thomas Canton Mass
REMARKS. (Please give here any matter of interest relating to Your Service.)
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name George Edward Thomas
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name George E. Thomas
AS APPEARS ON THE SERVICE ROLL
....... 12 December 1891
Date of Birth.
.....
DAY MONTH YEAR
Place of Birth.
........
Canton
mass
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service 096 Prospect Canton, mase
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Tim
de2 Messinger Canton Maso
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted.
Enlisted
Date and Place of Enlistment.
July 10, 17 Charlestown
Date and Place Where Drafted
Date and Place Where Mustered In or Reported for Duty July 1 0,17 Boston
Give Government Identification Tag Number. 63093
Co., Regt., Ship, or Service, First Assigned to and Date 5 th mass Supply Co
Other Regiments, Ships or Branches of Services, Transferred to and Dates. Supply Cp. 101 st. Ouf
Rank While in Service.
Wagoner
If Commissioned Officer Give Date of Commission.
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Newport News
Quera
eas
Any Service in American Expeditionary Force or Canadian or Allied Force Overseas amer an
yes
If so, Date and Ship from the United States or Canada
Ellosentia nov 1.0.17
Port Sailed From for Overseas
Newport news
Date of Arrival Overseas
Dec 7, 1917
Port of Arrival Overseas.
St nazaire
Date and Ship Sailed Returning Home.
mar 289 america
Port Sailed from Returning Home
Break
Date of Arrival from Overseas.
april 5, 1919
Place of Arrival in United States
Boston
Important Places Where Stationed Overseas.
Rubenville Chesney Men le Paul
Participated in What Battles and Dates of Same.
Cheman de Dame
Deb 18. Tout april 1918, Chateau
Thierry July 1918. Verdun Oct 1918.
argonne
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 28. 1919
Where Discharged from Service
Camp Devenus
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. Leather finisher
Married or Single married
If Ever Married, Maiden Name of Wife (or Wives)
martha & miller
Date and Place of Marriage to Wife (or Wives)
Noxupad Dec 10, ' 19
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 & Thomas, Canton
Name of Mother and Place of Residence.
mary
11
(Deceased)
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
5 / 4 3 /4"
150 las.
Your Height in Feet and Inches.
Your Complexion-White or Colored
White
Color of Your Eyes .....................
Brown
Color of Your Hair
Black
Give Names and Addresses of Two or Three of Your Most Intimate Comrades alton Carter. Cambridge masa
Golden. Dorchester, Mass
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 Walter francis Titus
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name malter 8. Titus
AS APPEARS ON THE SERVICE ROLL
Date of Birth.
3
DAY
Jun
e
1893
MONTH
YEAR
Place of Birth
....
Canton
mass
CITY OR TOWN
STATE OR COUNTRY
Place of Residence When Entering the Service 306 Mask, Canton Mass
STREET AND NUMBER CITY OR TOWN STATE
Place of Residence at Present Time 1306 Wash. Canton Mass
STATE
Enlisted or Drafted Enlisted
STREET AND NUMBER CITY OR TOWN Boston,
Date and Place of Enlistment
June 14, 1917
Date and Place Where Drafted
Date and Place Where Mustered In or Reported for Duty Recruiting Sta. Boston June 14.
Give Government Identification Tag Number.
Co., Regt., Ship, or Service, First Assigned to and Date 7th Co. U. S. navy,
Electrical Class
Other Regiments, Ships or Branches of Services, Transferred to and Dates Mine laying forces, Brandenburg, Louisville. 4 Base 17-18
Rank While in Service. Electrician 3/c
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
yes
If so, Date and Ship from the United States or Canada
Gloucestershire, aug 12,18
Port Sailed From for Overseas
Halifax
Date of Arrival Overseas
aug 26, 18
Port of Arrival Overseas.
Glasgow
Date and Ship Sailed Returning Home
may 22'19 Lamiville
Port Sailed from Returning Home.
Liverpool
Date of Arrival from Overseas.
June 1,'19
Place of Arrival in United States
Hoboken
Important Places Where Stationed Overseas.
Base 18 Inverness
Base #17 almeno
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 Influenza
Base 17×18 Hospitals
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 20 1919
Where Discharged from Service
Hingham
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.
Electrician
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.
Frederick Titus Canton,
Name of Mother and Place of Residence Emma 4
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
5' 18 3 /4"
142 lbs.
Your Height in Feet and Inches.
Your Complexion-White or Colored white
Color of Your Eyes.
Hazel
Color of Your Hair
Brown
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Rodney Reed Colebrook n. H Frederic Kinder, Marblehiel miss DI, West Highland ave Norfolk, Va
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 liere any matter of interest relating to Your Service.)
ha submarine aug 1918, off coast of Geland, Sank arabic
GERMAN WAR SERVICE RECORD of Canton, Mass.
Name
Gilbert Talman
COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY
Name Gilbert Talman Jr.
AS APPEARS ON THE SERVICE ROLL
Date of Birth. ............. 23 December
DAY
MONTH
1897
YEAR
Place of Birth
Canton
CITY OR TOWN
mass
STATE OR COUNTRY Place of Residence When Entering the Service 95 Rockland, Cantou Mass.
STREET AND NUMBER
CITY OR TOWN
STATE
Place of Residence at Present Time.
95 Rockland, Canton, Mass
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted.
Enlisted
Date and Place of Enlistment
Boston Navy Yard, July 30, 1918.
Date and Place Where Drafted ....
Date and Place Where Mustered In or Reported for Duty Sept 4, Bumpkins Os
Give Government Identification Tag Number.
Co., Regt., Ship, or Service, First Assigned to and Date
U. S. n. P. S.
Other Regiment=, Ships or Branches of Services, Transferred to and Dates
Officina
material School, Dec 2018
Takefield Nov 22 - Dec 2018
Rank While in Service apprentice Seaman Ensign
If Commissioned Officer Give Date of Commission. april 19, 1919
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service Pumpkins Is Wakefield, Cambridge Officers School
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. april 19, 19.19
Where Discharged from Service
Cambridge
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. Student
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
Gilbert Talman, Canton
Name of Mother and Place of Residence
Helen
.V. 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
Have You a War Risk Insurance Policy
no.
Give Number of Policy. .........
What Was Your Weight When Entering the Service
5' 10'
145 lbs
Your Height in Feet and Inches.
Your Complexion-White or Colored
White
Color of Your Eyes ..
Color of Your Hair
Brawn
Give Names and Addresses of Two or Three of Your Most Intimate Comrades Charles . Kimball, Cambridge mago Frederick Lockwood, Manchester n.H. Scott Keith, Greenfield maso
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 Villa May Jeffrey Garner COMPLETE DADE. NO INITIALS. PLEASE WRITE PLAINLY
Name Villa May Jeffrey AS FARS ON THE SERVICE ROLL
Date of Birth 30th September
DAY MONTH YEAR
1886
nova Scotia Place of Birth Digby CITY OR TOWN STATE OR COUNTRY Place of Residence When Entering the Service $ 65 High St. Canton Mass.
STREET AND NUMBER CITY OR TOWN STATE
Place of Residence at Present Time. le Meridian, Mississippi Box 800
STREET AND NUMBER CITY OR TOWN STATE
Enlisted or Drafted. Enlisted
Date and Place of Enlistment Seht 28.1917
Canton. Mass
Date and Place Where Drafted
Date and Place Where Mustered In or Reported for Duty Oct. 3-1917 Camp Sevier - Greenville S.C.
Give Government Identification Tag Number.
Co., Regt., Ship, or Service, First Assigned to and Date army Nunca Corp Oct. 3-1917
Other Regiment:, Ships or Branches of Services, Transferred to and Dates.
Rank While in Service.
army nurse
If Commissioned Officer Give Date of Commission.
If Appointed Officer Give Date of Every Appointment
If Not Overseas, Where Stationed While in Service
Camp Servies Svemille - 2.C.
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 14 1919
Where Discharged from Service
Camp Sevier Greemille S. C.
For What Reason Discharged from Service.
Illness at home
If Given Medal of Honor, Give Metion and Date. ......... If Given Citation or Certificate of Merit, Give Service and Date
Other Medals and Foreign Decorations
Kind of Oeeupation Before War Service .... , Superintendent of hospital
Married or Single Single at time of service
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 IIis Death or Divorce
Names, Ages and Places of Birth of All Children, if any
..
Name of Father and Place of Residence
albert O. Jeffrey, Bloomfield, Digly Co. Nova Scotia
..
Name of Mother and Place of Residence
Charlate S. Treffeny.
Are You Without the Foregoing Relatives in This Country
If So, Have You a Brother or Sister Here
Tua brothers
And if so, Give Full Name and Address of Either or Both
John a. Jeffrey, Washington
Willis At Treffrey, Stratford new Stampshine
Have You a War Risk Insurance Poliey.
Give Number of Poliey
T 725011
What Was Your Weight When Entering the Service
120 lbs
Your Height in Feet and Inches.
5ft. 21/2 fiches
Your Complexion-White or Colored
White
Color of Your Eyes.
Gray
Color of Your Hair
Blanke
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 Reeord 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 Le Given to Set a Government Headstone.
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