Date of ledger entry: 6/30/1960.
Single or Married: MARRIED.
What Race: WHITE.
Residence: 6226 PERNOD ST LOUIS MO.
Charge To: KRIEGSHAUER FUNERAL HOME.
Address: 42285 S KINGSHIGHWAY ST LOUIS MO.
Order Given By: .
How Secured: .
Veteran State War: .
Occupation of the Deceased: INSURANCE ADJ.
Age: 55 YRS.
Date of Funeral: .
Time of Funeral Service: .
Funeral Services At: .
Clergyman: .
Clergyman's address: .
Religion: .
Resided in the state: .
Cause of Death: LACERALION OF BRAIN FRACTURED SKULL.
Certifying Physician: H.J. SWEETS CORONER.
Certifying Physician's address: HANNIBAL MO.
Body to be shipped to: .
Interment At: ST JAMES RITHIN MINN.
