Coroner's Book

425 / 1028

P. 1\1
Days
...if(rntnn <tTnunt y <tTnrnnrr
:,
!i ®ffirr...
---== ......101 e. •
1Vhite-G8t 2 -}hi18 Femal
Xativity -�
:A, •� f\3
, r9V-, � A. M.
Age � Months
How long in County?
P. M.
_ 1....Days
�-Single- .A W:iJ j,J iv �'; idowu. - Occupation.
Father's Name 'Jf/�� · Mother's Name�
Estate Next Friend___ __ _________
Place of Death_____ _________ Date of Death______________
Body Found_ _ _____________ _________________
Place of Accident
�ature Injuries___ ____ _____ _ _ ________ _____ ___ _ _
Cause of Death ��- - �4��
Post Mortem-------------- ---------- --------------
�ames of Juryn1en________________________ _____�------
�ames of Witnesses______________ _ _ __________________
Undertaker '-k,_.//}'U��. , '-'·,i' .,...Fees �1d_______
CRIPTION WHEN UNKNOWN
Height._______ Hair______ _ Eyes_____
Nose_ _ _____ Chin_ ______ Neck_ ______ Teeth_ _____
Beard_____ ______ _ _ _ _ Mustache__ __ _ __________
Scars, Marks, De�r1nities, Etc,-- - - - - -------·----------------
- - --- -----
Clothing-- -- -------------
Contents of Pockets, Etc.,____ _________
Ren1arks: ________ _ ________ _ _
VE RDICT:_________ __ ____ _ __ _____� ______
�
@�
Signed Coroner.