|
Name |
Wm. Webster |
|
Book & Page No. |
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|
Registration No. |
86 |
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Place of Death |
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Residence |
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Date of Birth |
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|
Age |
45y |
|
Gender/Color |
Male/white |
|
Marital Status |
Married |
|
Widow |
|
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Place of Birth |
|
|
Father |
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|
Father’s Place of Birth |
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Mother |
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|
Mother’s Place of Birth |
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Occupation |
Laborer |
|
Informant |
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Informant’s Address |
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Date of Death |
05-28-1894 4pm |
|
Cause of Death |
Valvular disease of heart; duration: 6wks |
|
Attending Physician |
W.C. Payne of |
|
When Signed |
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Place of Burial |
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Date of Burial |
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Funeral Director |
D&W of |
|
Date of Return |
09-19-1894 |
|
Local Registrar |
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|
District |
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Explanation of Cause of Death |
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