Name |
|
Book & Page No. |
|
Registration No. |
|
Place of Death |
|
Residence |
|
Date of Birth |
Feb. 14, 1855 |
Age |
71 yrs, 7 mos, 12 dys |
Gender/Color |
Male/white |
Marital Status |
Married |
Widow |
|
Place of Birth |
|
Father |
Nels Nelson |
Father’s Place of Birth |
|
Mother |
Gulne Englebritsen |
Mother’s Place of Birth |
|
Occupation |
Retired farmer |
Informant |
Mrs. Rachel Nelson |
Informant’s Address |
|
Date of Death |
Oct. 8, 1926 |
Cause of Death |
Pyenephipis |
Attending Physician |
R.R. Hansen, |
When Signed |
|
Place of Burial |
|
Date of Burial |
Oct. 12, 1926 |
Funeral Director |
Pursel & Pursel, |
Date of Return |
|
Local Registrar |
|
District |
|
Explanation of Cause of Death |
|