Date of ledger entry: 7/31/1960.
Single or Married: SINGLE.
What Race: WHITE.
Residence: .
Charge To: WILFORD LES SHANNON.
Address: PALMYRA MO.
Order Given By: W.L. SHANNON.
How Secured: PER.
Veteran State War: .
Occupation of the Deceased: .
Age: .
Date of Funeral: 8/1/60.
Time of Funeral Service: 2 P.M..
Funeral Services At: SPRAGUE FUNERAL HOME.
Clergyman: REV J.W. BROWN.
Clergyman's address: PALMYRA.
Religion: .
Resided in the state: .
Cause of Death: PROLOPSE OF UMBILICAL CORD.
Certifying Physician: DR. J.W. WELL.
Certifying Physician's address: PALMYRA MO.
Body to be shipped to: .
Interment At: GREENWOOD.
