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101
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Inquest No.
Received NA tice �
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,
19_J�,/
__
A. M.
_
P. M.
Name
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Rcsidfnce
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Whitc-�le-Female.
Age
J
I
Years
____Months
�ativity
How long in County?
__
Married-Single-Widow-Widower.
Days
Father's Name
Mother's Name.
______ _
_
_
___
_
_
Estate
ext Friend
______________
_
Place of Death ,,y -- --.,,-__,_ -,: , r
::i · • -
--;;::
,
Place of
Nature Injuries
_
__
__
_
_
__
___
_
_ _
______
_
___ __
______
__
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Post Mortem
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Names of
Jurymen
_
_
__
_
_
__
__
___
___
_
_
______
_
__
____,________
Names of Witnesses____________________________________
Undertaker -�.
4-rrn�
Fees Paid
________
_
Height
Nose
Beard
DESCRIPTION WHEN UNKNOWN
Weight
_____ _
Chin
______ _
Hair
__ _ ___
_
Eyes.
____
Neck
Teeth.
_____
_
Mustache
_
_______
___
____
____
Scars, Marks, De�r1nities, Etc,
- -
---
-
---
-
-
-
-
--�
-
-
- -
--
-
-----
-
Clothing
-
-
-----
- - - -
----
- -==
Contents of Pockets, Etc.,
_
__
__
_
___
Remarks:
__
______
_
_ _
_____
_
_ _ _
__
_ __ _
_ ___
____
__
VE RDICT:
_
_
______
_ ___
_
_
__
_
_
__
_
_
__
__
__
_
_
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_
_
_
_ _
_
_
Signed
Coroner.