Date of ledger entry: 6-1-1955
Single or Married: WIDOWED
What Race: COLORED
Residence: PALMYRA MO
Charge To: CAPILLA COLEMAN
Address: PALMYRA
Order Given By: CAPILLA COLEMAN
How Secured: INS.
Veteran State War:
Occupation of the Deceased: HOUSEWIFE
Age: 67 YEARS
Date of Funeral: 6-4-55
Time of Funeral Service: 2 P.M.
Funeral Services At: PARK CHAPPEL BAPTIST
Clergyman: REV. JACKSON
Clergyman's address: QUINCY ILL
Religion: BAPTIST
Resided in the state: LIFETIME
Cause of Death: CARCENOTOSIS CARCENOMA R. BREAST
Certifying Physician: DR. J.W. WELL
Certifying Physician's address: PALMYRA MO
Body to be shipped to:
Interment At: GREENWOOD
