World War records : Canton, Massachusetts, 1917-1918, Part 4

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 4
USA > Massachusetts > Norfolk County > Canton > World War records : Canton, Massachusetts, 1917-1918 > Part 4


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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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 May 30-1918


Give Government Identification Tag Number. 3193252 0


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


8th Co 152nd Debut


Brigade


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


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 Comp Upton- Mapbank wy


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.


Daniel Selvan Canton. Mass


Name of Mother and Place of Residence


Tellie Sehan


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 Le 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


Florence


Lehan


PLEASE WRITE PLAINLY


Name


COMPLETE NAME. NO INITIALS. Lehan


AS APPEARS ON THE SERVICE ROLL


Date of Birth .......


1


november


1893


DAY


MONTH


YEAR


Place of Birth


Canton


maso


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service/52 Bailey Canton Mass


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time 152 Bailey, Cantou Mass


STREET AND NUMBER CITY OR TOWN STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment


Date and Place Where Drafted.


June 27, 18. Canton Maso


Date and Place Where Mustered In or Reported for Duty Jun June 28, 18. Camp Dix, n.J


Give Government Identification Tag Number.


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


Co. 40. 153


Depot Brigade


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


Co. a. 312 Enquiero


87 th


Rank While in Service.


/c Private


If Commissioned Officer Give Date of Commission.


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service Camp Dix n.G. Camp Morgan n. ........


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.


Jan: 23


Where Discharged from Service


Camp Dix, n.A.


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.


Die


Letter


Married or Single


married


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


Katherine Crean


Date and Place of Marriage to Wife (or Wives)


Canton, apr. 29, 1920.


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.


Daniel Lehane, Carton Maso.


Name of Mother and Place of Residence.


nellie


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


5' 5 1/2"


5'5 /2" 133 lbs .


Your Height in Feet and Inches.


Your Complexion-White or Colored


white


Color of Your Eyes.


Bracon


Color of Your Hair


Brown


1


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 J.


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. 1 52 Barley St. Canton Mass


STREET AND NUMBER CITY OR TOWN STATE


Place of Residence at Present Time. 4830 G St.


Philadelphia - Penna


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


May 28.1918


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. Seaman 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


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 1


Name of Father and Place of Residence Daniel Schon Carton- Mass Name of Mother and Place of Residence. Mellie Lehan.


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. 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


Ilave 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


Maurice Lem kin


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name Maurice Lemkin


AS APPEARS ON THE SERVICE ROLL


Date of Birth .. ............ 24 november


1895


DAY


MONTH


YEAR


Vilno


Russia


Place of Birth


....


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service 190 Rockland Canton Mass


STREET AND NUMBER CITY OR TOWN STATE Place of Residence at Present Time 190 Rockland, Carton, Mass


STREET AND NUMBER CITY OR TOWN STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment.


Date and Place Where Drafted.


Canton mars


Date and Place Where Mustered In or Reported for Duty Sept 21, 17 Camp Devenus


Give Government Identification Tag Number. 2309642


Co., Regt., Ship, or Service, First Assigned to and Date Cor. 302 nd Suf.


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


7th Co. 1 st. and Trans. Co.


Co G 165 th Infantry


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 Devenus ayer


Camp merritt no Over


..


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


Port Sailed From for Overseas


Ttoboken n.C


Date of Arrival Overseas


March 20, 198


Port of Arrival Overseas


Break France


Date and Ship Sailed Returning Home


april 18 1919. Leviathan


Port Sailed from Returning Home.


Break France


april 25, 1919.


Date of Arrival from Overseas.


Hoboken n.g.


Place of Arrival in United States


Important Places Where Stationed Overseas.


Baccaratt,


Luneville, It again


Participated in What Battles and Dates of Same. Champagne


July 14, 1918.


Chateau Thierry July 26-31,1918


Wounded or Other Injuries Received in Action, Place and Date


machine gun


und Chateau Thierry July 31, 18


If Confined in Hospital, During What Time and Place


Base Hospital $9


aug. 2, 1918. Chatteau Rue.


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 6, 1919


Where Discharged from Service


Camp Deveno Mare


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 Spreader- Rubber Works


Married or Single


married


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


Sadie Freedman


Date and Place of Marriage to Wife (or Wives)


Nov. 10, 1917. 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


..


Name of Father and Place of Residence.


David Lemkin, Vilno, Russia


Name of Mother and Place of Residence.


mary


Are You Without the Foregoing Relatives in This Country


yes


If So, Have You a Brother or Sister Here.


Brother


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


Benjamin Lemkin


Have You a War Risk Insurance Policy


no


Give Number of Policy


What Was Your Weight When Entering the Service


135 lbs


Your Height in Feet and Inches.


5' 7'


Your Complexion-White or Colored


White


Color of Your Eyes.


....


Braun


Color of Your Hair


Braun


Give Names and Addresses of Two or Three of Your Most Intimate Comrades Lewin Freedman 190 Rockland, Canton Morris Chaffin, 14 Eleaf


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


alatta may Lentell


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


AS APPEARS ON THE SERVICE ROLL


Date of Birth ................ 30


may


1890


DAY


MONTH YEAR


Place of Birth. Providence


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service. York Canton, Maso.


STREET AND NUMBER CITY OR TOWN STATE


Place of Residence at Present Time ne Mekelanova, Ul C. 147, Praha-Cz. Slov CITY OR TOWN STATE


STREET AND NUMBER


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 Many


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


Rank While in Service.


Nurse


If Commissioned Officer Give Date of Commission.


If Appointed Officer Give Date of Every Appointment


If Not Overseas, Where Stationed While in Service


Newport, R.L.


Chelsea


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. George R. Lentell Canton


Name of Mother and Place of Residence alottan


Are You Without the Foregoing Relatives in This Country


If So. Ilave You a Brother or Sister Here.


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


Have You a War Risk Insurance Policy.


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


What Was Your Weight When Entering the Service


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 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 Benjamin Russell Lentell


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name Benjamin Rue


le Lentel


AS APPEARS ON THE SERVICE ROLL


Date of Birth.


march 22


1893


DAY


MONTH


YEAR


Place of Birth.


Canton,


CITY OR TOWN


..... ...... masa


STATE OR COUNTRY


Place of Residence When Entering the Service York, Canton Mass.


STREET AND NUMBER CITY OR TOWN STATE


Place of Residence at Present Time


York, Canton Mass.


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted.


Drafted


Date and Place of Enlistment. Canton mars, Deb. 26, 1918.


Date and Place Where Drafted


Date and Place Where Mustered In or Reported for Duty Camp Devens," ".


Give Government Identification Tag Number. 1681471


Co., Regt., Ship, or Service, First Assigned to and Date Headquarters Co. 302 Auf, Mar. 15,1918.


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


520 th. Co. D. Engineer


91 st. Div. 364th. Ind. Co. C. Oct 28 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


Quero


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


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


aquitania, July 5, 1918


Port Sailed From for Overseas


New york


Date of Arrival Overseas


July 12, 1918


Port of Arrival Overseas.


Liverpool, Eng.


Date and Ship Sailed Returning Home.


arizaba march 25, 1919.


Port Sailed from Returning Home.


St nazaire France


Date of Arrival from Overseas


april 2, 1919.


Place of Arrival in United States


Hoboken n.C.


Important Places Where Stationed Overseas


Bordeaux, Belgium


Poules Deunge, alsene, Lemans.


Participated in What Battles and Dates of Same ..


Ilandere- Oct 28- Nov. 11.


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 30, 1919


Where Discharged from Service


Camp Deveno Masa


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. Plasterer


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 Palmer Canton Mass.


Name of Mother and Place of Residence


alotta


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 110 llo


Your Height in Feet and Inches.


..........


5'2'


Your Complexion-White or Colored


White


Color of Your Eyes.


...........


Braun


Color of Your Hair


Black


Give Names and Addresses of Two or Three of Your Most Intimate Comrades William Jenkins, Rochester mass R. L. Johnson Brownville, 20


Have You a Photograph of Self, in Service Uniform, to Give Town no


If Foregoing Record is of One Deceased, Give Date of Deatlı


Give Place of Death and Place of Burial


Give Burial Lot Number ......


Any Monument or Headstone Marked to Deceased Where Buried


Any Memorial for Deceased in Other Cemetery Than Where Buried


If Grave is Unmarked Will Permission be Given to Set a Government Headstone.


Name and Address of Person Filling Out This Record of Deceased


REMARKS. (Please give here any matter of interest relating to Your Service.)


GERMAN WAR SERVICE RECORD of Canton, Mass.


Name


Prescott Wilmarth Lentill


..


COMPLETE NAME. NO INITIALS. PLEASE WRITE PLAINLY


Name


Prescott MLentell


AS APPEARS ON THE SERVICE ROLL


Date of Birth. ....... 15 may


1891


DAY


MONTH


YEAR


Place of Birth


Providence


P.S.


CITY OR TOWN


STATE OR COUNTRY


Place of Residence When Entering the Service ..


ce York, Canton, Mass


STREET AND NUMBER


CITY OR TOWN


STATE


Place of Residence at Present Time.


Fall River Mass.


STREET AND NUMBER


CITY OR TOWN


STATE


Enlisted or Drafted


Enlisted


Date and Place of Enlistment Fariaignes france Oct 1, 1917.


Date and Place Where Drafted


Date and Place Where Mustered In or Reported for Duty Laissons, Och1, 1917.


Give Government Identification Tag Number. 249047


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


203 Water Train, a.E.D. aug 19, 1918


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


eco


Any Service in American Expeditionary Force or Canadian or Allied Foree Overseas ame an


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


Rochaneau July 25,17


Port Sailed From for Overseas


new york


Date of Arrival Overseas


July 4


4, 1917


Port of Arrival Overseas.


Bordeau Orange


Date and Ship Sailed Returning Home. Roma. May 10, 1919.


Port Sailed from Returning Home


Mareailles,


Date of Arrival from Overseas.


may 27, 1919


Place of Arrival in United States


new york


Important Places Where Stationed Overseas.


Laissons,


St nazaire


Verdun


meuse, arine,


....


Participated in What Battles and Dates of Same.


It Michiel Meuse


drive Sector (with French)


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 9 9 1919


Where Discharged from Service


Camp Devens


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 Certificate from french.


Kind of Occupation Before War Service. Clothing in Business 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




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