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Narue
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Residence � 0
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Inquest No.
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Months
P. M.
Days
Nativity
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How long in County?
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�d-Single-�-�ver.
Occupation
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Father's Name
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Cw0 Mother's Name���
Estate
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Next Friend
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Place of Death
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Date of Death
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Body Found
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Place of Accident
---------
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Nature Injuries
_
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Canse of Death
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Post Mortem
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James of Jurymen
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.�ames of Witnesses
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Undertaker
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p.. �� Fees Paid
DESC IPTION WHEN UNKNOWN
Height
Nose
Beard
Weight
____ _ _ _
Hair
___ _ __
_
Eyes
_______
Chin
_____ _ _
Neck
____ _ _
Teeth
______
Mustache
_ _ _ _ _ ____________
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Marks, Defurmities, Etc.,
___
_
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_ _ _ _
______
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Clothing
---
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Contents of Pockets, Etc.,
____
Remarks:
____
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_ _
_
___
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VERDICT:_
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Signed
Coroner.
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