|
Name |
John Anderson |
|
Book & Page No. |
Book 2, p.1 |
|
Registration No. |
3 |
|
Place of Death |
|
|
Residence |
|
|
Date of Birth |
|
|
Age |
1y |
|
Gender/Color |
Male/white |
|
Marital Status |
|
|
Widow |
|
|
Place of Birth |
|
|
Father |
|
|
Father’s Place of Birth |
|
|
Mother |
|
|
Mother’s Place of Birth |
|
|
Occupation |
|
|
Informant |
|
|
Informant’s Address |
|
|
Date of Death |
05-07-1891 12m |
|
Cause of Death |
Pneumonia result of whooping cough |
|
Attending Physician |
U.C. Payne, |
|
When Signed |
|
|
Place of Burial |
|
|
Date of Burial |
05-08-1891 |
|
Funeral Director |
|
|
Date of Return |
09-29-1891 |
|
Local Registrar |
|
|
District |
|
|
Explanation of Cause of Death |
|