Date of ledger entry: 12-2-1949
Single or Married:
What Race: WHITE
Residence:
Charge To: MYRTLE B. PHILLIPS
Address: 1320 CHAMPA ST DENVER COLO
Order Given By: MYRTLE B. PHILLIPS
How Secured:
Veteran State War: W W 2
Occupation of the Deceased:
Age: 29 YEARS
Date of Funeral: 12-3-49
Time of Funeral Service: 1:30 P.M.
Funeral Services At: FIRST BAPTIST CHURCH
Clergyman: REV. SUTTERFIELD
Clergyman's address: PALMYRA MO
Religion: BAPTIST
Resided in the state: LIFETIME
Cause of Death:
Certifying Physician:
Certifying Physician's address:
Body to be shipped to: SHELBYVILLE, MO
Interment At: