|
Name |
|
|
Book & Page No. |
|
|
Registration No. |
353 |
|
Place of Death |
Timber Creek Twp |
|
Residence |
|
|
Date of Birth |
04-16-1844 |
|
Age |
66y |
|
Gender/Color |
|
|
Marital Status |
|
|
Widow |
|
|
Place of Birth |
|
|
Father |
|
|
Father’s Place of Birth |
|
|
Mother |
Sternes |
|
Mother’s Place of Birth |
|
|
Occupation |
Housewife |
|
Informant |
Emma Snider |
|
Informant’s Address |
|
|
Date of Death |
03-22-1910 |
|
Cause of Death |
Last illness, mitral insufficiency, 40dys |
|
Attending Physician |
R.M. Whalen |
|
When Signed |
03-25-1910 |
|
Place of Burial |
|
|
Date of Burial |
03-22-1910 |
|
Funeral Director |
Howard Wilbur |
|
Date of Return |
|
|
Local Registrar |
|
|
District |
|
|
Explanation of Cause of Death |
Congestive heart failure |