Date of ledger entry: 6-4-1948
Single or Married: MARRIED
What Race: WHITE
Residence: 408 KENTUCKY ST. QUINCY
Charge To:
Address:
Order Given By:
How Secured: MET. INS.
Veteran State War:
Occupation of the Deceased: LABOROR 347-24-9815
Age: 62 YEARS 15 DAYS
Date of Funeral: JUNE 7 48
Time of Funeral Service: 2:30 P.M.
Funeral Services At: LUTHERN CHURCH
Clergyman: BECKER
Clergyman's address: PALMYRA MO
Religion: LUTHERN
Resided in the state:
Cause of Death: CEREBRAL HEMORRHAGE
Certifying Physician: H. G. SENNOCK
Certifying Physician's address: QUINCY ILL.
Body to be shipped to:
Interment At: