Date of ledger entry: 10/15/1967.
Single or Married: SINGLE.
What Race: WHITE.
Residence: 9201 OUTLOOK DRIVE OVERLAND PARK KANS.
Charge To: HOGE FUNERL HOME.
Address: 8024 SANTA FE DRIVE OVERLAND PARK KANS.
Order Given By: .
How Secured: .
Veteran State War: NO.
Occupation of the Deceased: STUDENT.
Age: 20 YRS.
Date of Funeral: 10/18/1967.
Time of Funeral Service: .
Funeral Services At: .
Clergyman: .
Clergyman's address: .
Religion: .
Resided in the state: .
Cause of Death: BROKEN NECK AUTO ACCIDENT.
Certifying Physician: DR. H. SWEETS.
Certifying Physician's address: HANNIBAL MO.
Body to be shipped to: OVERLAND PARK KANS HOGE F.H..
Interment At: SUNY SIDE CANEY KANS.
