535 / 1028
P, M
_
Days
...!(rutnu C!Tnuut y C!Tnrnurr
's
®ffirr...
====
�101
====
Inquest No,
r
J/JA.{�::J- :v
,
19..4.___l,
__
A. M.
Name
lu-1'\)_
\..
a
'-'�
Q/\
1
v
'-"
Residence
.
'2-
0 3 D
;<).
ccZf
M.
�
'
" ' '
<,
White :et,lund Male-�male.
Age
2
l.,
Years
____
Months
Nativity
How long in County?
__
_
P. M.
Days
��d-Single-�w-VJ.i.4e.wer.
Occupation
Jn
a
oA.-<-.&-1��
Fat1
1
er's Name
Mother's Name
_______ _ ____
_
Estate
Next Friend
�
Place of Death
...2 o
3a
A
�
od?f
,,Jf
,
Date of Death
,S
Body Found
�
1
,
V
!'lace of Accident
o-
JI
Nature Injuries
_ __ -
-
-
- --
--- - --------
- - - -
-------
Cause of Death
�ki.� LIQ,µ!)�
�
h/U4,J
Post Mortem
---
---
- -
-
- - --
- - - -
- - -
-
--
- -
---
-
--
-
--
-
Names of Jurymen
____ _ _ _ ______________
_____�-----
Names of Witnesses
____________ _ _ _ ____ ___ ________
Cudertaker
�
Ji
(';,
Fees
.
ESCRIPTION WHEN UNKNOWN
Paid
__
_
_ ___
Height
Weight
_ ____
_
Hair
_
_ _
_
__
Eyes
Nose
__-;---- - -
Chin________
Neck
______
_
Teeth
_______
Beard
___
Mustach.e
_
_ __ _ _ _
_
_____
_
_
_
s��,
Marks, Defurmities, Et�,�:
- ------- -- - ----- -- --------
Clothing
-
�
---
--
-
-
--
------ -=
==
-
Contents of Pockets, Etc.,
--
-
-
--
----
�
--
-
-
Remarks:
___
- - - ---- - - ----- - -----
VERDICT:
__
_
--
---
-
- -
--
---
- �
Signed
Coroner.