Coroner's Book

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101
Inq uest No. :leczjiv , e § Not 1 � � - - J
Name��& -
--, 19_$.c,. �A . M. _P. M.
Residence �/Ei,n,J__ ___ __ _ ___
White-�ed-��Eerna)e Age � 9 �Years ____ Months ____ Days
Nativity bJ7fntn-/ How long in County?___ _
�---:_,.1 s· 1 -x,1:,·d "'l'.d o ·
1�- 1ng e ,vl ow=--tvt owe1. ccupat10n___ _ ___ ____ ____ _
Father's Name ��� Mother's Name_ __ __ ______ _
Estate_________ _ _ __ _ Next Friend_____________ _
Place of DeathJ:Ott't}·u-
Body Found •, 4
� � Date of Death
• #·-:??< ,¢tc:7r�e-r:2
Place of Accident._ __________ _ _
Nature Injuries_____ _ _ _ ______ ___ _ _ _ _____ _
Cause of Death__�'--""".._.. ___ �- --- - -- - - --- -- - -----
Post Mortem- - -- -�· - - - ------------- -
Names of Jurymen________________ _ _ _ _ ____ _ _
Names of Witnesses_____ ___ _____ _ ___ _ ________
Undertaker____________________ Fees Paid_ ____:___
DESCRIPTION WHEN UNKNOWN
Height_ _ ____ Weight_ _ _ _ Hair__ Eyes__ _ _
Nose____ __ _ Chin_ _ _ __ __ Neck_ ___ _ Teeth___ _
Beard_ _ _ __________ Mustache_____________ _
Scars, Marks, Deformities, Etc·,-------------· - -- - - -- --
Clothing- ------ ------ - ------ - - -- -----
Contents of Pockets, Etc., -- - ---�- - ---- - - --- ----- --
Remarks:_ __ _________________________ _ __
VERDICT:____ _ ________ �-t-- -
Signed__________________Coroner.