Date of ledger entry: 11/27/1966.
Single or Married: MARRIED.
What Race: WHITE.
Residence: PHILADELPHIA M R #1.
Charge To: MATILDA LOVELACE.
Address: R #1 PHILADELPHIA MO.
Order Given By: MATILDA LOVELACE.
How Secured: INS.
Veteran State War: WW 2.
Occupation of the Deceased: STORE KEEPER.
Age: 50 YRS.
Date of Funeral: 11/30/1966.
Time of Funeral Service: 2 P.M..
Funeral Services At: SPRAGUE FUNERAL HOME.
Clergyman: DAVID HATHAWAY.
Clergyman's address: .
Religion: .
Resided in the state: LIFE.
Cause of Death: PROBAL GASTRIC BLEEDING.
Certifying Physician: DR. J. WELL.
Certifying Physician's address: PALMYRA.
Body to be shipped to: .
Interment At: GREENWOOD.
