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WAR RECORD

First went into action (place): Sept 26, 1918

(date): Argonne County of [illegible]

Participated in the following engagements: St. Michiel Reserve, Argonne, Lys[illegible]

Cited, decorated, or otherwise honored for distinguished services (give circumstantial accounts of exploits, including dates and places where performed, also by whom and in what manner the honors were bestowed): :

Killed in action, killed by accident, died of wounds, died of disease, wounded, gassed, shell-shocked, taken prisoner:

Nature of casuality: While in Russia as a transport office. Appendix busted

(place): Russia, transferred to Germany and I was operated on by a German surgeon

(date): May 20 1919

Nature of casuality:

(place):

(date):

Nature of casuality:

(place):

(date):

Under medical care:-

Name of hospital: "House of John"

Location: Pressiche Holland east Prussia

From (date): May 26, 1919

to (date): Aug 4, 1919

Name of hospital:

Location:

From (date):

to (date):

Name of hospital:

Location:

From (date):

to (date):

Name of hospital:

Location:

From (date):

to (date):

Permanently disabled (through loss of limb, eyesight, etc.) (specify disability): Abdominal wounds

Arrived at (American port):

on (ship): Riolus

Date: Sept 5 1919

(from): Brest

Discharged from service at (place): San Francisco, Cal

(date): October 31, 1919

as a (rank): Captain

RETURN TO CIVIL LIFE

Occupation after the war: Dental Surgeon

If a change of occupation was occasioned by reason of disability acquired in the service, describe the process of re-education and readjustment, and indicate the agencies or individuals chiefly instrumental in furnishing the new occupations::

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