Date of ledger entry: 8/10 1922.
Single or Married: .
What Race: .
Residence: HUSECAMP MO..
Charge To: J. H. CLARK.
Address: PALMYRA MO..
Order Given By: .
How Secured: W. A. RINEHART.
Veteran State War: .
Occupation of the Deceased: CHILD.
Age: 8 YEARS 11 MONTHS 10 DAYS.
Date of Funeral: 8/11-1922.
Time of Funeral Service: 8/11-2:30 P.M-1922.
Funeral Services At: CLARENCE MO..
Clergyman: .
Clergyman's address: .
Religion: .
Resided in the state: .
Cause of Death: TYPHOID.
Certifying Physician: HAMLIN.
Certifying Physician's address: PALMYRA MO..
Body to be shipped to: CLARENCE MO..
