DEATH CERTIFICATE

TRANSCRIPTIONS L SURNAMES


County of: Pulaski
Township or road district or village:
Primarydist no.:
Full name: Dora LEE
Residence no.:
Gender: Female
Color or race: Black
Single, married, widowed or divorced: Single
If married, widowed or divorced
Husband of (or) wife of:
Date of birth:
Age: 19 years, 8 months 10 days
Occupation of deceased: Hoousekeeping
Birthplace: Tennessee
Name of father:
Birthplace of father:
Maiden name of mother:
Birthplace of mother:
Informant:
Address:
Filed:
Date of death: October 16, 1904
Cause of death: Typhoid Fever
Place of Death: Mound City, Illinois
Signed:
Place of burial:
Date of burial:
Undertaker:
Address:

 

County of: Pulaski
Township or road district or village:
Primarydist no.:
Full name: James LOVE
Residence no.:
Gender:
Color or race: American
Single, married, widowed or divorced: Single
If married, widowed or divorced
Husband of (or) wife of:
Date of birth:
Age: 2 years, months days
Occupation of deceased:
Birthplace:
Name of father:
Birthplace of father:
Maiden name of mother:
Birthplace of mother:
Informant:
Address:
Filed:
Date of death: December 25, 1889
Cause of death: Typho-Malaria, Fever
Place of Death: Mounds
Signed:
Place of burial: Shiloh
Date of burial:
Undertaker:
Address:
 

 

 


 

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