| Decedent's Given Name | Clarence S. |
Chancy | Decedent's Surname |
| Location | Ames |
207 | Enumeration District |
| Enumerator | E.R. Chamberlain |
209 | Family Number |
| Age | 3 |
M | Sex |
| Color | W |
Single | Marital Status |
| Birth Place | Iowa |
Ohio | Father's Birth Place |
| Mother's Birth Place | Pa |
| Occupation |
| Month of Death | March |
Unknown | Cause of Death |
| How long in Story Co. | |
| Where illness contracted |
| Attending Physician | Kaynor & Merideth |
| Physician's Statement - Primary Cause |
| Physician's Statement - Immediate Cause | Exhaustion |
G.A. Meredith | Physician's Signature |
| Enumerator Remarks: | |
The following is not taken from the schedule. See the introduction for an explanation of sources.
| Birth Date | abt 1877 |
Mar 1880 | Death Date |
| Head of Household Given Name | Miles |
Chancy | Head of Household Surname |
| Grave Marker in Story Co.? | No |
| Cemetery |
| Grave Marker Information: | |
| Transcriber Comments: | |