Date of ledger entry: 1-27-1952
Single or Married: SINGLE
What Race: WHITE
Residence: PALMYRA MO
Charge To:
Address:
Order Given By:
How Secured:
Veteran State War:
Occupation of the Deceased:
Age: STILLBORN
Date of Funeral: 1-28-52
Time of Funeral Service:
Funeral Services At:
Clergyman:
Clergyman's address:
Religion:
Resided in the state:
Cause of Death: STRANGULATION FROM CORD
Certifying Physician: DR. P. H. STUHLMAN D.O.
Certifying Physician's address: PALMYRA
Body to be shipped to:
Interment At: