Coroner's Book

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Inquest No. 7iJ R w ive d!Y tice__ �� _, �. 19M,
Name {Ft-� �.. 4.L£ bd
-
_A. M.
Residenc e_ lao 1.-� t, IO� � 0;;;;;;£_,?f I{,
White-�-Male-JswaJe. Age �ears J'Montbs
Nativity� vi{. 1"1 How long in County?_
P. �I.
& � Days
Mani.iMii,. £ingle-Wid.9w W�r. Occupation �
Father's Name� 1� Mother's Name � 5..,_�
Estate Next Friend------------- Place of Deatl:;e:: Body Found � Date of Death __________
�v--g(Lh,4L, {)If;
Place of Accident________________
Nature Injuries_________________
Cause of Death-.--c��tL���1-/J.('--=--��--�---
Post Mortem _________________
Names of Jurymen______________
Names of Witnesses_______________________________
Undertaker______________________ Fees Paid
DESCRIPTION WHEN UNKNOWN
Height _______ Weight_______ Hair___ _ __ E yes _
Nose________ Chin________ Neck__ _ __ Teeth____
Beard_________________ Mustache ________________
Scars, Marks, Deformities, Etc., __________________________
Clothing-------------·------- _______________
Contents of Pockets, Etc.,____________
Remarks=------------------- ------ ---------�
VE RDICT:_________________________
Signed____________________Coroner.
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