532 / 1028
\.,
...if(rntnn <nnunt y <nnrnnrr�
!i
®ffirr...
.
i...
--.....�-
�1(]=;
P. M.
Inquest
No,_ E R
ecei ?!i v
Notice
.
< �
2-
,
19
{if
__
A.,.. � .
Name
_ �--- �
-
·
'2£/�
'
'"."\.
·
:
.,; �
R�d�ce
__
�
�
-
�u��
�
�/
�
J
���-
�
·
--
-
- - - -
--
�
-
--
-
White-�Male-� Age
�
-i3-'
Years
Months
Days
Nativity
c18"3fa.,U,.L
How long in County?
_ _
_
M� ied-Single-�v
-�wer.
Occupati
o
n�
--------
Father's Name
J:ra,U,RA
)j\e�
Mother's Name�,uwrw�=Y'.-« ,......,Y::'.�
-
-
Estate
tf
Next Friend
...-
.,
Place of Death
Date of Death a
,S
..2,
/
f
b
Body Found �
�
f'(J
-
/"'
4-rf4
h1
�
Place of Accident
__ _ _ ___________
_
Nature Injuries
__ _ _ ____________ ____________
_ _
Cause of Death
)W'�-<.,t<"'I
/
C)L-,:t,..,li\/,-
'
Post Mortem
__ _ ____ _ _ _____
_
Names of Jurymen_____________ _ _ ___ _ _
__ _____ __
Names of Witnesses ___________ _ _ ____________ _________
Undertaker
�,
�
,,_,,J
�,rt;;,
Paid
___
_
DESCRIPTION WHEN UNKNOWN
Height
_______
Weight_______
Hair
___
__,
_
�
�
-
Eyes
___
_
Nose________
Chin__ _ __ _
Neck
_______
Teeth
_ _ _
Beard
___ _ ___ _ _ _____
Mustache_________________
Scars, Marks, Deformities, Etc., _ _ _ _ ____________ _ ____________
Clothing---- --- - - -- ---- -
Contents of Pockets, Etc.,
__ __ ________ _ _ _____________
R
eina
�---
-
- - - - -- - -
--
-
-
-
- --
- -
---- --
-
--
- -
-
V E RDICT:
_________________ _
Signed
Coroner.
I