Page 129 DATE: June May 31, 1933
NAME of DECEASED: Infant Chocherill [Churchill?] SEX: COLOR: White
CHARGE TO: Estate ORDER GIVEN BY:
Date of Funeral: Place of Death:
Funeral Services
Time of Funeral Services: Clergyman:
Certifying Physician: His Residence:
Cause of Death:
Date of Death:
Occupation of the Deceased:
Single, Married, Divorced: Religion:
Aged: years, months, days Birth Place:
Father: Thomas Fullerton Birth Place:
Maiden Name of Mother: Birth Place:
Name of Wife:
Informant: Address:
Size and Style of Casket:
Manufactured by:
Interment at - Cemetery
