| Surname | Given | Middle | Cause | Monthly Rate | Certificate No. | Original Date | Post Office | County |
| ALVOOD | Osbourne | E. | chr. Diarr. and dis. Of l | $12.00 | 97885 | | Lake City | Missaukee |
| ANDERSON | William | S. | wd. L. hip | $4.00 | 149096 | Nov. 1877 | Lake City | Missaukee |
| BARKER | Lorenzo | A. | wd. L. foot | $4.00 | 117157 | June 1872 | Lake City | Missaukee |
| CORWIN | Hally | | wd. Of l. forehead | $2.00 | 204639 | Mar. 1882 | Lake City | Missaukee |
| DYER | Sophronia | | mother | $8.00 | 109592 | Mar. 1868 | Lake City | Missaukee |
| LUNG | Henry | | wd. R. lung | $18.00 | 124948 | | Lake City | Missaukee |
| PIERSON | Abraham | E. | dis. Of kidneys | $4.00 | 179306 | Dec. 1880 | Lake City | Missaukee |
| RITCHEY | Joseph | | loss part r. index fing. | $2.00 | 158351 | Mar. 1879 | Norwich | Missaukee |
| SHULTZ | Nicholas | | wd. L. thigh. | $6.00 | 44163 | June 1865 | Lake City | Missaukee |
| THAYER | Christopher | J. | wd. L. thigh. | $12.00 | 114849 | | Lake City | Missaukee |