| Decedent's Given Name | Lulu M. |
Burns | Decedent's Surname |
| Location | Collins Twp |
212 | Enumeration District |
| Enumerator | William V. Dawes |
163 | Family Number |
| Age | 3/12 |
F | Sex |
| Color | W |
Single | Marital Status |
| Birth Place | Iowa |
Ohio | Father's Birth Place |
| Mother's Birth Place | Iowa |
| Occupation |
| Month of Death | Sep |
Lung fever | Cause of Death |
| How long in Story Co. | 3/12 |
| Where illness contracted |
| Attending Physician | S.T. Goodman |
| 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 | Jun 1879 |
Sep 1879 | Death Date |
| Head of Household Given Name | Fullen |
Burns | Head of Household Surname |
| Grave Marker in Story Co.? | |
| Cemetery |
| Grave Marker Information: | |
| Transcriber Comments: | Surname is difficult to read and may be incorrect. |