Coroner's Book

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6, -- . M. P. M. Inquest �� � eived No '. ice �-- _ _____.._"'-! �- _ _:__, 19
Name� �� ...i\'I :'f� _ ____ _ ____ ---- Residence Un d,,� """'�ht l: � fb..,d=____J��-___..r�--...�l,.."'4. "J r--- White-�stie:d-Male-1ie@Hl8le. Age ___ _ �== =years __8 __ Months
Nativity �Con 4 � 'fJ How long in County?_
l\�niZti Single(! '1tiiitw: Vi" ? ocer. Occupation
Father's Name �7Jl.. � o Mother's Namen��!!d.�'2---fLLD..��m4a.c..,....
Estate Next Friend_ _,__ _-.--_ _ __ __
Place of Death�------�- - --Body Found � Fr�
Date of Death_�,r.a�__::::��-�/_L__J.,i�
\
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:________________ _ _ ____ _ ___________
VE RDICT:______________ __________ _
Signed____________________ Coroner.