1904 POLK COUNTY DEATH CERTIFICATES Lucretin Nelson Female White Widow Informant: W.T. May DOD: Jan 5, 1904 Buried: McMinnville, OR Jan 7, 1904 Undertaker: W.T. May Simon George Howard Male White DOB: June 30, 1904 Single Birthplace: Monmouth, OR Father: Claude G. Skinner Birthplace: Tole co. Kentucky Mother: Ethel E. Hall Birthplace: Dallas, OR Informant: Claude G. Skinner Independence, OR DOD: Jan 5, 1904 12:30am Cause: Pneumonia Oedema of lungs Duration: 14 days Buried: Independence June 6, 1904 Undertaker W. L. Bird?? 5 miles SW of Dallas Mary Bailey Wright Female White DOB: Nov. 30, 1848 Married Birthplace: IL Father: George Haworth Birthplace: TN Mother: Mary Thornton Birthplace: OH Occupation: Tailor Informant: Levi Wright Dallas, OR DOD: Jan 14, 1904 5pm Cause: acute appeudicitus Duration: 6 days MD Wm S. Cary of Dallas, OR Falls City 2 miles NE Esaac Hughes Male White DOB: May 20, 1881 Single Birthplace: Falls City, OR Father: Isaac Hughes Birthplace: Wales Mother: Mary Roberts Birthplace: Wales Occupation: Farmer Informant: L Pfandhoefer, MD Falls City, OR DOD: January 15, 1904 10pm Cause: Shooting himself (accidently as much as can be ascertained Duration: 2 days Buried: Ioof Cemetery Falls City, OR January 17,1904 Independence Ann Macaulay Female White DOB: September 7, 1830 Widow Birthplace: Chester England Father: Joseph Fodess Birthplace: Chester England Mother: Auria Lightfoot Birthplace: Chester England Occupation: House Keeping DOD: January 31, 1904 12:15 am Cause: Intenstinal Obstruction Duration 4 days EL Ketchewer MD Buried: Portland, OR Feb 5 or 6 1904 Undertaker: Josse & Bice Independence, OR Weril ?? Male White DOB: July 22, 1831 Single Birthplace: Rome, NY Father: Wm Norton Occupation: Minister of the Gospel Informant: Jas R. Shepard Salem, OR RFD #1 DOD: February 7,1904 approx: 6:30 am Cause: Consumption Duration: about 1 year Buried: Zena, OR 2/8/1904 Henry Lturges Male White Married Occupation: Printer DOD: February 13,1904 Cause: Chronic Brights Disease FE Smith MD, Salem, OR Perrydale Ebenejer C Keyat Male White DOB: November 15, 1827 Married Birthplace: New York Father: Gideon Keyt DOD: February 1, 1904 4:15 am Cause: Senile Decay Duration: about 1 year RC Hunter MD Buried: Bethel February 19, 1904 Undertaker: W. Chapman, Dallas Dallas David Cosper Male White DOB: October 29, 1828 Married Birthplace: OH Father: Daniel Cosper Birthplace: PA Mother: Margaret Marr Birthplace: PA Informant: H.B. Cosper, Dallas OR DOD: February 18, 1904 11 am Cause: Pneumonia Duration: 8 days Wm S Cary MD, Dallas OR Falls City Maggie M Mervin Female White Married Birthplace: Kansas Father: Matthews Miller Birthplace: OH Mother: Sarah Hamar Brthplace: Indiana DOD: February 16, 1904 Cause: Embolism Duration: 14 days L. Pfandhoefer MD Falls City OR Usual residence: Watkiins’ Mill Buried: IOOF Cemetery Independence Gilbert Mc Cabe Male White Single Father: P.H. Mc Cabe Occupation: Laborer Informant: Thos Pomeroy DOD: March 5, 1904 Buried: IOOF Cemetery Undertaker: H. St. Jasperson, Independence, OR Independence Curtis Herbert Baker Male White DOB: September 27, 1882 Single Birthplace: Neosho MO Father: Marcus A. Baker Birthplace: Dayton, OH Mother: Lizzie Roeden Birthplace: Near Mt. Vernon MO Occupation: Labor Informant: Arthur G. Baker, Independence, OR DOD: March 5 1904 Buried: IOOF Cemetary Undertaker: H H Jasperson, Independence Independence Alfred Henderson Simpson Male White DOB: January 30, 1841 Married Birthplace: Lawraence Co. AR Father: R. William Simpson Birthplace: Germany Mother: Rebbecca Lasiter Occupation: Farmer Informant: Reuben H. Simpson, Monmouth OR DOD: April 11, 1904 9 pm Cause: Brights Disease Paralysis Monmouth Leah Nichols Female White DOB: December 25, 1823 Widow Birthplace: Kambridge Maryland Father: Heny Treago Birthplace: England Mother??? Birthplace: England Informant: Lala Nichols, Monmouth, OR DOD: March 14, 1904 1 am Cause: Bronchitis Duration: 10 years Contributory: Old age Buried: Monmouth March 15, 1904 Undertaker: Jasperson, Independence Independence 10 Miles SW Anna M Bigler Female White DOB: March 10, 1828 Widowed Birthplace: Switzerland Father: John Lehsnew Birthplace: Switzerland Mother: ??? Yoggi Birthplace: Switzerland Occupation:House Work DOD: March 20, 1904 8am Cause: Chronic Asthma, liver & Kidney disease Buried: Amity, OR March 23, 1904 Undertaker: HH Jasperson, Indp Independence Hawisah Miller Female White Widow Birthplace: IN Father: ??? Maharr Birthplace: IN Mother ??? Birthplace: England DOD: March 23, 1904 6 am Cause: Dropsey & heart Mers Samuel T. Lobach DOB: Feb 14, 1826 Married Birthplace: NY Father: Joseph ?unison Birthplace: New Jersey Mother: Margaret Galtry Informant: S.T. Lobach DOD: March 28, 1904 8 am Cause: Pneumonia Buried: Zena, OR March 29, 1904 Undertaker: W Rigdon, Salem Lerm E. Ketchum Male White DOB: Jan 10, 1832 Married Birthplace: NY Father: Joes Ketchum Birthplace: NY Mother: M Hodges Birthplace: NY Occupation: Farmer DOD: March 29, 1904 2 am Cause: Permicious Annersia Buried: IOOF Cemetery, Independance, OR Undertaker: H. H. Jasperson, Independance Dallas Elsie Pierce Female White DOB: 1886 Single Informant: B. H. CcCallon MD DOD April 7, 1904 Cause: Pneumonia Complications & Measles Dallas Enoch L. Ingalls Male White DOB: July 11, 1831 Married Birthplace: Bangor Maine Occupation: Mechanic Informant: Mrs Ingalls, Dallas DOD: April 7, 1904 Cause: Hemaplegia Dallas Leta Peirce Female White DOB: 1896 Single Informant: B H McCallon MD, Dallas DOD: April 10, 1904 4:00am Cause: Pneumonia Complicating Measels Michigan Maria Haase Female White DOB: April 1, 1815 Married Birthplace: Germany DOD: April 10, 1904 Buried: Zena April 11, 1904 Undertaker: W. Rigdon, Salem Dallas--2 miles N. Sarah Ann Dunlap Female White DOB: June 11, 1843 Married Birthplace: Winchicomb, England Father: Elisha Hughes Birthplace: Winchicomb, England Mother: Martha Philkuos Birthplace: Winchibomcb, England Informant: Elisha Phillips DOD: April 14, 1904 4:00am Cause: Accute Tuberculosis L.S. Woods MD, Dallas, OR Buried: Dallas Cemetery April 15, 1904 Undertaker: L. Chapman, Dallas, OR Mary Ann Anderson Female White 1829 Widow Birthplace Missiour Mother: Mary A. Riggs DOD April 15, 1904 Cause: Apoxley Addrew Podvin Male White 1885 Single Birthplace MN Father: Jos Podvin Birthplace US Mother: Nettie Polly Birthplace: Italy DOD: May 15, 1904 2 am Cause: Peritonitis Claud D. Simpson Male White DOB: May 22, 1880 Single Birthplace: Polk Co. OR Father R. H. Simpson Birthplace: Polk Co., OR Mother: Miram A. Hener Birthplace: Polk Co., OR Occupation: School Teacher DOD May 21, 1904 7 pm Cause: Typhoid Feaver F.R. Weiden Male White DOB: Jan 28, 1839 Married Birthplace: Ireland Occupation: Farmer DOD: May 21, 1904 5 am Cause: Rhemotism Monmouth John A. Knower Male White DOB Nov 25, 1824 Father: John A. Knower Occupation: Minister DOD: June 10, 1904 6am Cause: La Grippe Falls City Mary J. Syron Female White DOB: May 10, 1827 Married Birthplace: Albana, OH Father: William Franklin Birthplace NJ Mother: Ackermann DOD: June 19, 1904 7pm Cause: Paralysis Buried: Odd Fellows Cemetery Falls City, OR Ettia Mather Female White DOB: January 19, 1880 Married Birthplace: Cadillac, Mich Father: W.H. Livingston Birthplace: NY Mother: Addie Micnatt Birthplace: IL DOD: June 25, 1904 6pm Cause: Puerperal Septicaemia Buried: City Falls City Not Named Female White DOB: July 2, 1904 Birthplace: Coast Range Mill Father: John H. Vernon Birthplace: Linn Co. OR Mother: Minnie Piatt Birthplace: Linn Co., OR DOD: July 2, 1904 11pm Cause: Inanition Monmouth Mary White Female White Widow Birthplace: Aberden Co. Scotland Father: John Wilson Birthplace: Aberden Co. Scotland Mother: Mary Yongson Birthplace: Aberden Co. Scotland DOD: July 7, 1904 3 pm Cause: Uremic poisoning and Arthroma Contributory: Brights Disease Mathias Kubin Male White DOB: Dec 8, 1821 Married Birthplace: Bohemia Aus Fathr Moseph Kubin Birthplace: Bohemia Aus Occupation: Farmer DOD: July 15, 1904 6pm Cause: Heart and Kidney disease Dallas Un named Female White May 23, 1904 Birthplace Dallas, OR Father: Sam Ray Birthplace: Missouri Mother: Boyd Birthplace: Indiana DOD: July 23, 1904 Cause: Unable to retain Nourshment from birth Polk Station Angenetta Querring Female White June 20, 1901 Birthplace: Polk Station Father: J.W. Quering Birthplace: Russia Mother: Susie Reddekoph Birthplace: Alberta Canada DOD: Aug 1, 1904 4pm Cause: Arsenical Poisoning Dallas Catherine Shelton Female White Sept 6, 1820 Widow Birthplace: Smith Co., VA DOD: Aug 2, 1904 6 am Cause: Pulmonary obstruction Monmouth Essie Edna Simpson Female White DOB: May 12, 1882 Single Birthplace: Lewisville, Polk Co., OR Father: Ruben H. Simpson Birthplace: Lewisville Polk Co. OR Mother: Mirum A. Herren Birthplace: Benton Co., OR DOD: Aug 4, 1904 11pm Cause: Pulmonary Tuberculosis Buried: IOOF Independence Buena vista William M. Cooper Male White age 32 years Married Occupation: Logger DOD: Aug 8, 1904 4pm Buried: city View Cemetery Dallas un named Male White DOB: Aug 7, 1904 Birthplace: Dallas Father: Frank V. Brown Birthplace: Dallas, OR Mother: Mabel Myers Birthplace: Schuyller Co., PA DOD: Aug 24, 1904 3 am Cause: Hepatetis Dallas Florence Gerturde Simonton Female White DOB: May 15, 1883 Single Birthplace: Lawrence co. PA Father: James Simonton Birthplace: Lawrence Co., PA Mother: Malinda Kozer Birthplace Mifflin Co. PA DOD: Sept 3, 1904 6pm Cause Cerebral Congestion Independance Joseph Roner Male White DoB 1847 Married Birthplace: Bohemia Father: Joseph Roner Birthplace: Bohemia Mother: Teressa Birthplace: Bohemia Occupation: Farmer DOD: Sept 6, 1904 Cause: Accidental drowning Will River Buried Albany, OR Dallas Mary E. Gibson Female White DOB: Oct 25, 1839 Widowed Birthplace Pike Co., IL Father ???Hirans Mother: Mary E. Hirans DOD: Sept 2, 1904 7:30 am Cause: Uninary Suppression Monmouth Jessie Gross Male White DOB: March 8, 1830 Married Birtholace: Randolph Co., MO Father: J.M. Gross Birthplace: IL Mother: Rachel White Birthplace: IN Occupation: Wagonmaker DOD: Sept 21, 1904 4am Independence Paloma Mae Clodfelter Female White DOB: July 3, 1904 Birthplace: Independence Father: Clarence Clodfelter Birthplace: Iowa Mother: Amanda Griffa Birthplace: Kansas DOD: Sept 25, 1904 3:45 am Cause: Cholera Infautum Buried: IOOF Cemetery Independence Henry Hill Male White DOB: Jan 20, 1824 Married Birthplace: NY Father: Ladue Hill Mother: Eliza Aurelia Taylor Occupation: Farmer DOD: Oct 17, 1904 12 Buried: Rickerall, OR Falls City Dorothea M. McGinnis Female White DOB: Oct 7, 1902 Birthplace: Falls City, OR Father: Wm McGinnis Birthplace: New Lisbon, OH Mother: Elma Campbell Birthplace Muscatina, IA DOD: Oct 7, 1904 1:00am Entero Colitis Independence Leonard Honna Male White DOB: June 5, 1904 Birthplace: Independence Father: James L. Honna Birthplace: PA Mother: Elsie Irvine Birthplace: Polk Co, OR DOD: Oct. 4, 1904 9pm Buried IOOF Cemetery 3 mi NW of Salem Hidde G. Stonebrink Male White DOB: Feb 7, 1812 Widower Birthplace: Holland Father: Gerben Stonebrink Birthplace: Holland Mother: Bauwkje Fisher Birthplace: Holland Occupation: Farmer DOD: Oct, 9, 1904 3pm Cause: Senility Independence Grace L. Gillispie Female White age 7 years Birthplace: Monroe Co. Mich Father: E.B. GIllispie Birthplace: Birmingham, Mich Mother: Orilla Grace Miller Birthplace: Lansing, Mich DOD: Oct 17, 1904 11pm Cause: Pneumonia Buried: IOOF Cemetery Independence Harris L. Wing Male White Single Birthplace: Russia Father: Lewis Wing Birthplace: Russia Mother: Sivia Wing Birthplace: Russia Occupation: Farmer DOD: Nov 6, 1904 7:30am Cause: Heart Buried Ahonia Sholom Cemetery Dallas Veita E. yron Female White DOB: Oct 30, 1898 Birthplace: OR Father: Marion Syron Birthplace: OR Mother: Mollie Stakely Birthplace: OR DOD: November 28, 1904 Cause: Pnuemonia Buried: IOOF Cemetery Ballstom John McCollough Male White Father: George Mc Collough Birthplace: Scotland Mother: Jane Holmes Birthplace: Scotland Occupation: Farmer DOD: Dec 9, 1904 Buried Plesant Hill Cemetery Monmouth Ruby Fay Denney Female White DOB: Nov 14, 1904 Birthplace: Monmouth, OR Father: S.C. Denney Birthplace:McCoy OR Mother M.P. ??? Birthplace: McCoy OR DOD: Dec 17, 1904 2pm Cause: Pneumonia Buried: Monmouth McCoy Maggie E. ToziesrFemale White DOB: Nov 2, 1852 Married Birthplace: IA Father: Solomon Bishop Birthplace: KY Mother: Sabitha Miller Birthplace: OH Informant A.R. Tozier DOD: Dec, 22, 1904 3am Dallas Charles Robert Farley Male White DOB July 18m 1858 Married Birthplace: Polk Co., OR Father: Robert Farley Birthplace: Campbell Co., TN Mother: Lydia Cooper Birthplace: Hamilton Co. OH Occupation: Farmer Informant: May Farley DOD: Dec 23, 1904 Cause: Pneumonia John A Williams Male White DOB: March 7, 1865 Married Birthplace IN Father: John A. Williams Birthplace: IN Mother: Lucinda Price Birthplace: IN Occupation: Farmer Informant: Martha Williams DOD: Dec 23, 1904 4pm Cause: Pneumonia Monmouth Hennery J. Butler Male White DOB: Sept 27, 1844 Birthplace: Pitsfield, IL Father J.B.V. Butler Birthplace: NH Mother: Elizabeth Ingals Birthplace: Madison O. Informant: J. B. Butler DOD: Dec 25, 1904 9pm Cause: Organic Heart Disease Independence Female White Baby Iliff DOB: Dec 18, 1904 Birthplace: Independence Father: Charles S. Iliff Birthplace: Washbern, IL Mother: Lila Henrietta Butler Birthplace: Washbern, IL DOD: Dec 26, 1904 1:00[, Cause: Premature birth (7 months) Dallas Elizabeth May Whiteham Female White DOB: May 9, 1868 Married Birthplace: Nebraska Father: David Boals Birthplace: PA Mother: Hannah J. Boyd Birthplace: PA Informant: Harvey Boals DOD: December 27, 1904 3am Cause: Pneumonia Buried: IOOF Cemetery Independence E.G.Heath Male White DOB: July 6, 1842 Married Birthplace: Pleasaant Mills IN Father: George Heath Birthplace: IN Mother: Rachel Robuck Heath Birthplace: IN Occupation: Potter DOD: December 30, 1904 3 pm Died suddenly and alone with his wife. Buried: IOOF Cemetery