| Decedent's Given Name | William |
Poulda | Decedent's Surname |
| Location | Warren Twp |
198 | Enumeration District |
| Enumerator | Wm M. Hardin |
P.R. | Family Number |
| Age | 1 |
M | Sex |
| Color | W |
Single | Marital Status |
| Birth Place | Iowa |
| Father's Birth Place |
| Mother's Birth Place | |
| Occupation |
| Month of Death | Nov |
Diphteria | Cause of Death |
| How long in Story Co. | |
| Where illness contracted |
| Attending Physician | Dr. Squires |
| Physician's Statement - Primary Cause |
| Physician's Statement - Immediate Cause | |
| Physician's Signature |
| Enumerator Remarks: | |
The following is not taken from the schedule. See the introduction for an explanation of sources.
| Birth Date | abt 1878 |
Nov 1879 | Death Date |
| Head of Household Given Name | |
| Head of Household Surname |
| Grave Marker in Story Co.? | |
| Cemetery |
| Grave Marker Information: | |
| Transcriber Comments: | Surname difficult to read and probably incorrect. |