Coroner's Book

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Inquest NJ>. � Received Notice�� \ , �., 19�.J,I __ A. M. · P. M.
Name�.0 '1M ·.£3 -
Res 1 '.L , 7 'ln��
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Wm � F"""'9te.- Age 't 'K Years ____ Months --- Nativity How long in County?__
Days
Married-Single-Widow-Widower. Occupation_____ ________________
Father's Name Mother's Name________________
Estate . Next Friend__________ ______
:�:: � o :: th 5 � Date of Death d:\ L,-3
:,.__I ___
Place of Accident__________ ___ _______ _
Nature Injuries �"C�,...e_o=: j,� �
� � r ,� - - -----
--------- �------- -· ' -------
Cause of Death _ __ _ _
Post Mortem ___ _ _____ _ _ _____ _
Names of Jurymen_________ _ _ ___ _ _____ ___ _________
Names of Witnesses____ _ _ _ _ _ _ _____________________
Undertaker � l� Fees Paid_____
DESCRIPTION WHEN UNKNOWN
Height._______ Weight_______ Hair___ _ Eyes_ _
Nose.______ _ Chin_ _ _ __ Neck___ _ __ Teeth ___ _
Beard Mustache___ _ _ ____________
Scars, Marks, -De�rmities, Etc., ________________ ____________
Clothing- --- --------------
- -------------- ----------- --------------------------- - Contents of Pockets, Etc., ________________ _ _ _ _____ _____
Remarks:_________ _ _ _ _ _ _______________________
VE RDICT: ___________________________
Signed Coroner.
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