|
Name |
Chas. Ralph Williams |
|
Book & Page No. |
|
|
Registration No. |
89 |
|
Place of Death |
|
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Residence |
|
|
Date of Birth |
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|
Age |
6y |
|
Gender/Color |
Male |
|
Marital Status |
Single |
|
Widow |
|
|
Place of Birth |
|
|
Father |
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|
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 |
07-20-1894 |
|
Cause of Death |
Dyptheria |
|
Attending Physician |
W.H. McClain of |
|
When Signed |
|
|
Place of Burial |
|
|
Date of Burial |
07-20-1894 |
|
Funeral Director |
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|
Date of Return |
08-27-1894 |
|
Local Registrar |
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|
District |
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|
Explanation of Cause of Death |
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