▁H ERE BY ▁C ERT IF Y , ▁That ▁I ▁attended ▁dece ased ▁from ▁June ▁ 2 2 , ▁ 1 9 1 9 ▁to ▁June ▁ 2 7 , ▁ 1 9 1 9 ▁That ▁I ▁last ▁saw ▁him ▁alive ▁on ▁June ▁ 2 7 , ▁ 1 9 1 9 ▁And ▁that ▁death ▁occurred ▁on ▁the ▁date ▁stated ▁above , ▁at ▁ 4 ▁p . m . ▁ ▁THE ▁CA USE ▁OF ▁DE ATH ▁was ▁as ▁follows : ▁Par al ysis ▁of ▁the ▁bow ls ▁following ▁Ac ute ▁append ic itis ▁open ▁ 3 ▁w ks ▁before , ▁& ▁second ▁open ▁ 2 ▁days ▁ago ▁_ ____ ___ ( .... ...) ▁y rs ▁_ ____ _ w k ▁_ ____ __ d ys . ▁Cont rib ut ory ▁pt oma ine ▁poison ing ▁from ▁Ice ▁cre am ▁( .... ) ___ y rs ▁_ __ w ks ▁ 3 ▁days ▁( Sign ed ) ▁H . ▁William ▁_ ____ __ 1 9 1 __( Address ) ▁Ch ipp ew a . ▁F alls , ▁Wis ▁▁ 1 8 ▁L EN G TH ▁OF ▁R ES ID EN CE ▁ <0x09> ( Not ▁given ) ▁ 1 9 ▁PL ACE ▁OF ▁B URI AL <0x09> DATE ▁OF ▁B URI AL ▁▁▁▁▁▁▁▁ ▁Forest ▁Hill <0x09> J une ▁ 2 9 , ▁ 1 9 1 9 ▁▁ 2 0 ▁U ND ER TA K ER ▁Mr . ▁P . ▁H ogs eth <0x09> Ch ipp . ▁F alls ▁ ▁Lew ▁Hol t ▁S