| Decedent's Given Name | Helen |
Larsen | Decedent's Surname |
| Location | Lafayette Twp |
200 | Enumeration District |
| Enumerator | Ole O. Roe |
65 | Family Number |
| Age | 29 |
F | Sex |
| Color | W |
Married | Marital Status |
| Birth Place | Norway |
Norway | Father's Birth Place |
| Mother's Birth Place | Norway |
Keeping house | Occupation |
| Month of Death | Jan |
Comsumption | Cause of Death |
| How long in Story Co. | 5 |
| Where illness contracted |
| Attending Physician | B.F. Allen |
| Physician's Statement - Primary Cause |
| Physician's Statement - Immediate Cause | Tubersl? |
B.F. Allen | Physician's Signature |
| Enumerator Remarks: | |
The following is not taken from the schedule. See the introduction for an explanation of sources.
| Birth Date | abt 1850 |
Jan 1880 | Death Date |
| Head of Household Given Name | Anfin J. |
Larsen | Head of Household Surname |
| Grave Marker in Story Co.? | No |
| Cemetery |
| Grave Marker Information: | |
| Transcriber Comments: | |