World War records : Canton, Massachusetts, 1917-1918, Part 3

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 3
USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 3


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 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 Kennally, Canton Mars


Name of Mother and Place of Residence.


Bridget


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


Ilave You a War Risk Insurance Policy.


no


Give Number of Policy. .......


..........


What Was Your Weight When Entering the Service


180 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


Brown


Give Names and Addresses of Two or Three of Your Most Intimate Comrades Joe I. Daly, 17W42& Lt, New York City Ed.J. Smith, 12543 Euclid ave Cleveland . Charles Heckel Laplan are Jamaica, ny.


Ilave You a Photograph of Self, in Service Uniform, to Give Town Uno


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 Deeeased 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 Clifford Renually


COMPLETE NAME. NO INITIALS PLEASE WRITE PLAINLY


Name


Vennally William


Clifford


/ AS APPEARS ON THE SERVICE ROLL


Date of Birth


22


march


1891


DAY


Place of Birth.


Canton


MONTH


YEAR


mass


....


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Services


252, Auburn Cincinnati, Ohio


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time 41


e41 Chapel, Canton Mars


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted.


Enlisted


Date and Place of Enlistment


May 22,1917 Cincinnati Chio


Date and Place Where Drafted Date and Place Where Mustered In or Reported for Duty July 15,17 Cincinnati


Give Government Identification Tag Number.


1166459.


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


8 th Co. 147 th.


ambulance Campo


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


147th ambulance Corpo. 112th


Sanitary Train


Rank While in Service ..


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 Montgomery, ala


Camp Stanley, Texas. Over


e


a


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 26,18 Placey


Port Sailed From for Overseas


Brooklyn, n.Y.


Date of Arrival Overseas


July 10, 1918.


Port of Arrival Overseas


Glasgow


Scotland


Date and Ship Sailed Returning Home


Mar. 13 19 montana


Port Sailed from Returning Home


Brest


Date of Arrival from Overseas.


march 24,'19


Place of Arrival in United States


Hoboken


Important Places Where Stationed Overseas.


Baccarat Verdun,


...


Ir mihiel Flanders


Participated in What Battles and Dates of Same


argonne July 31 - Sept 12, 18


It mihiel Oct 6-14 18. Jeres Oct 30-


Nov 5'18 and Now 9-11,'18.


Wounded or Other Injuries Received in Action, Place and Date


If Confined in Hospital, During What Time and Place


Baccarat


aug 10 -25, 18.


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 25, 1919


Where Discharged from Service


Camp Sherman, Ohio


For What Reason Discharged from Service.


Service 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 Storage que Battery


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 Kennally, Canton, Mass


Name of Mother and Place of Residence.


Bridget


"


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.


yes


Give Number of Policy. .........


...........


1336373


What Was Your Weight When Entering the Service


165 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 Brown


Give Names and Addresses of Two or Three of Your Most Intimate Comrades H. D. Graesser 53064th St. Newport Ky. Chas. E Jones, 402. 8. main; Middleton Ohio alphonse Tappe 13th . Main, Cucinati Theo 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 Patrick Renney


......


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


Edward Patrick Renney


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


....


30


may


1885


DAY


MONTH


YEAR


Place of Birth


Little Falls


CITY OR TOWN


n.4


STATE OR COUNTRY


Place of Residence When Entering the Service. 46 Centre Canton Mare


STREET AND NUMBER CITY OR TOWN STATE


Place of Residence at Present Time 46 Centre, Canton Masa.


STREET AND NUMBER CITY OR TOWN STATE


Enlisted or Drafted. Enlisted


Date and Place of Enlistment


Boston, June 6 1917


Date and Place Where Drafted


Date and Place Where Mustered In or Reported for Duty. Boston June 6, 1917


Give Government Identification Tag Number.


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


Receiving. Ship, Boston


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


Rank While in Service.


Engineman 2/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


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. June 21,1919


Where Discharged from Service


Boston


For What Reason Discharged from Service.


End of War.


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 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.


PS Kenney 4, Sherman Little Falls.


Name of Mother and Place of Residence.


Bridget


. n.y.


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


ITave You a War Risk Insurance Policy.


Give Number of Policy.


What Was Your Weight When Entering the Service


5' 7'/2''


147/2 lbs.


Your Height in Feet and Inches


Your Complexion-White or Colored


White


Color of Your Eyes.


Hazel


Color of Your Hair


Bra


Give Names and Addresses of Two or Three of Your Most Intimate Comrades John C. Murphy, 35 Beach Gian ny


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.) made 14 tripe across


GERMAN WAR SERVICE RECORD of Canton, Mass.


Name


Charles Hibbard Kunne


....


..


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


Charles


.......... .......


AS APPEARS ON THE SERVICE ROLL


Date of Birth


8


September


1895


DAY


MONTH


YEAR


Place of Birth


Little


CITY OR TOWN


New Hampshire


STATE OR COUNTRY


Place of Residence When Entering the Service. Canton mass.


STREET AND NUMBER CITY OR TOWN STATE


Littleton n.2


Place of Residence at Present Time.


R.S.D#2


STREET AND NUMBER CITY OR TOWN STATE


Enlisted or Drafted


Enlisted


Date and Place of Enlistment.


June 20, 17. Little ton n. 2


Date and Place Where Drafted.


Date and Place Where Mustered In or Reported for Duty July 25,17. Berlin 91.21.


Give Government Identification Tag Number.


69435


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


June 20, 1917


Other Regiments, Ships or Branches of Services, Transferred to and Dates. COL 103duf.


aug 22, 17. Co.E. 107 the Supply Train. apr. 13,18.


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


0


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


yes


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


Sept. 27, 17 Lapland


Port Sailed From for Overseas


Hoboken


Date of Arrival Overseas


Oct 8 17


Port of Arrival Overseas


Liverpool


Date and Ship Sailed Returning Home.


may 7'19 Virginia


Port Sailed from Returning Home.


Brest


Date of Arrival from Overseas.


May 2019


Place of Arrival in United States


Newport News Va


Important Places Where Stationed Overseas.


Liffol le Grand


Pranthoy,


St Germain alsace


Chateau Thierry Marcerockdarf, Ger.


Participated in What Battles and Dates of Same


alsace May 18-July 21, 18


drive- Marne July 29- Queg 7' 18, Viene-alone


aug 26- Sept 6, 18, Meuse- argonne Sept26-


nov 1 1 8


Wounded or Other Injuries Received in Action, Place and Date


If Confined in Hospital, During What Time and Place march 14 - april 19 18.


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.


auto-mechanic


.


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


Henry V Kinice Littleton n.7


Name of Mother and Place of Residences


Senna


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


150 lles


Your Height in Feet and Inches.


5' 7 1/2"


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 Charles C. austin Manchester n. Frank Hanna abbotsford Wie Stanley Cheely, Coalport, Da


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


Jahn Fran


wie Lake


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name John Francis Lake AS APPEARS ON THE SERVICE ROLL


Date of Birth


4


June


1890


DAY


MONTH


YEAR


Place of Birth.


Blair


md


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service-


32 Highland, Cantou Mass


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time ..


32 Highland Canton mass


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment.


Date and Place Where Drafted


Oct 5, 1917 Camp Devens


Date and Place Where Mustered In or Reported for Duty


Oct 8, 1917


Give Government Identification Tag Number.


82176


Co., Regt., Ship, or Service, First Assigned to and Date Co.K. 302nd. Sud


Other Regiments, Ships or Branches of Services, Transferred to and Dates. Trapp m. 3rd Cavalry, mar. 8 1918


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


Camp Devens


Camp Gordon,


Overa


e


0


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


400


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


martha Washington Seb. 9,


Port Sailed From for Overseas


new york


Date of Arrival Overseas


Deb. 22 1918


Port of Arrival Overseas.


Break


Date and Ship Sailed Returning Home.


June 21 1990 Sinland


Port Sailed from Returning Home


Boston July 1,1920


Date of Arrival from Overseas


July 11,1920


Place of Arrival in United States


C


Boston


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 3, 1920


Where Discharged from Service


Campo Devino


For What Reason Discharged from Service.


If Given Medal of IFonor, 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. Conductor


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


Berij. n. Lake


Name of Mother and Place of Residence.


mary 8. Lake


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


14/ lbs


Your Height in Feet and Inches


....


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 Harry Service New york City James Day. Brockton mare Gym. murphy


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


Glorinah Lebens COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


DAY MONTH


YEAR


Place of Birth


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service.


STREET AND NUMBER CITY OR TOWN STATE


Place of Residence at Present Time ........


STREET AND NUMBER CITY OR TOWN STATE


Enlisted or Drafted.


Date and Place of Enlistment


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


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


Rank While in Service. If Commissioned Officer Give Date of Commission


If Appointed Officer Give Date of Every Appointment


If Not Overseas. Where Stationed While in Service


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 .......


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.


Name of Mother and Place of Residence.


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


Color of Your Eyes. ....


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 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 Jamen n. Lechas


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name James n. Lecha


AS APPEARS ON THE SERVICE ROLL


Date of Birth 10 September 1893


DAY


MONTH YEAR


Place of Birth.


ag. George


CITY OR TOWN


Estiana


Greece


STATE OR COUNTRY


Place of Residence When Entering the Service.


Wood, Canton Mars.


STREET AND NUMBER CITY OR TOWN STATE


Place of Residence at Present Time. 16 Capen Pl. Canton Mass


STREET AND NUMBER CITY OR TOWN STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment.


Date and Place Where Drafted. July 22'18 Carton Mass


Date and Place Where Mustered In or Reported for Duty July 22 1918


Give Government Identification Tag Number.


Co., Regt., Ship, or Service, First Assigned to and Date Co. C. 36 Infantry


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 Camp Deveres ayer Maso


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 31, 1918


Where Discharged from Service


Camp Deveno Mass


For What Reason Discharged from Service.


End of War


If Given Medal of IIonor, 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.


assistant Dyer


Married or Single Luigle


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.


Nicholas & Lechas, Greece


Name of Mother and Place of Residence marpaula. 11 'ו' 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


Ilave You a War Risk Insurance Policy


no


Give Number of Policy.


What Was Your Weight When Entering the Service


115 /2 Cho


Your Height in Feet and Inches.


4' 7 3/4'


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 angelo &Johnson, Canton, Maso Nicholas Baptis Jony Vlapas


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 Daniel J. Lehan COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name ..........


AS APPEARS ON THE SERVICE ROLL


Date of Birth


DAY MONTH YEAR


Place of Birth


CITY OR TOWN STATE OR COUNTRY


Place of Residence When Entering the Service. 152 Bailey St. Canton Mass


STREET AND NUMBER CITY OR TOWN STATE




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