Page 140 DATE: 6-12, 1934
NAME of DECEASED: Mrs. Ben Harryman (sic)
[Josephine E. (Peppers) Harriman] SEX: COLOR:
CHARGE TO: 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: Birth Place:
Maiden Name of Mother: Birth Place:
Name of Husband: [Benjamin Smith "Ben" Harriman]
Informant: Address:
Size and Style of Casket:
Manufactured by:
Body to be Shipped from Muscatine