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STATE:
Missouri
File Number:
306
Registered #91
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CERTIFICATE OF DEATH
MISSOURI STATE BOARD OF HEALTH
Record transcribed from original recorded public records to avoid violation of direct reproduction/copyright laws.
This is not an official copy, but research of official documents are listed here for the purpose of family research.
This page will give the researcher a reference number and the location of where to find this official document.
Document obtained from Erlene Dudley
Transcribed by Kevin Everingham |
| DECEASED
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DECEASED NAME:
Paul Everingham | SEX
M | DATE OF DEATH:
Jan 22, 1918 |
PLACE OF BIRTH:
St. Joseph, MO | Place of Death:
St. Joseph, MO | AGE
1d | Date of Birth:
Jan 21, 1918 |
OCCUPATION:
n/a | City of DEATH:
St. Joseph | County of DEATH:
Buchanan |
STATUS:
single | Time of DEATH:
8:30 P.M. | Color or Race:
White |
ADDRESS:
2307 S. 9th St. | Registrar & Date of Registration:
H.D. Lainater (Jan 28, 1918) |
| | PARENTS | FATHER:
N.G. Everingham (b.NY) | MOTHER:
Josephine Vest (b.MO) |
| | Informant | Informant:
G.Rock | Address:
916 (can't read) |
| | CAUSE
| IMMEDIATE CAUSE:
7 months, lived 12 hours | INTERVAL:
-- | CAUSE:
| INTERVAL:
- | CONTRIBUTORY:
not fully developed | PHYSICIAN:
M. C____? M.D. |
| | BURIAL | All Burial Information:
not legible.
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