| Decedent's Given Name | Berrent |
Sampson | Decedent's Surname |
| Location | Howard Twp |
199 | Enumeration District |
| Enumerator | Abel Olson |
4 | Family Number |
| Age | 2 |
M | Sex |
| Color | W |
| Marital Status |
| Birth Place | Iowa |
Norway | Father's Birth Place |
| Mother's Birth Place | Norway |
| Occupation |
| Month of Death | March |
Lung fever | Cause of Death |
| How long in Story Co. | |
| Where illness contracted |
| Attending Physician | Dr. B. Allen |
| 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 1877 |
Mar 1880 | Death Date |
| Head of Household Given Name | |
| Head of Household Surname |
| Grave Marker in Story Co.? | Yes |
Fairview Cemetery | Cemetery |
| Grave Marker Information: | Son of Wier Sampson. Died 18 Feb 1880. |
| Transcriber Comments: | |