|
Name |
Nellie |
|
Book & Page No. |
Book 2, p.1 |
|
Registration No. |
5 |
|
Place of Death |
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Residence |
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Date of Birth |
|
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Age |
|
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Gender/Color |
Female/white |
|
Marital Status |
|
|
Widow |
|
|
Place of Birth |
MO, resident of IA .5y |
|
Father |
|
|
Father’s Place of Birth |
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|
Mother |
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|
Mother’s Place of Birth |
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Occupation |
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Informant |
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Informant’s Address |
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Date of Death |
04-06-1891 4pm |
|
Cause of Death |
Measles, duration 4 days |
|
Attending Physician |
W.D. Campbell, |
|
When Signed |
|
|
Place of Burial |
|
|
Date of Burial |
04-07-1891 |
|
Funeral Director |
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Date of Return |
09-29-1891 |
|
Local Registrar |
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|
District |
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Explanation of Cause of Death |
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