| . |
STATE:
Missouri
File Number:
40110
Registered #1254
|
|
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
|
DECEASED NAME:
Ethel L. Everingham | SEX
F | DATE OF DEATH:
Dec 13, 1916 |
PLACE OF BIRTH:
MO | Place of Death:
St. Joseph, MO | AGE
8hrs | Date of Birth:
Dec 12, 1916 |
OCCUPATION:
n/a | City of DEATH:
St. Joseph | County of DEATH:
Buchanan |
STATUS:
single | Time of DEATH:
4:00 A.M. | Color or Race:
White |
ADDRESS:
(can't read it) | Registrar & Date of Registration:
D.O. Kelly (Dec 14, 1916) |
| | PARENTS | FATHER:
N.G. Everingham (b.New York) | MOTHER:
Josephine Vest (b.MO) |
| | Informant | Informant:
Thos Rock | Address:
916 Fred Ave. |
| | CAUSE
| IMMEDIATE CAUSE:
8 month gestation | INTERVAL:
- | CAUSE:
and not fully developed | INTERVAL:
- | CONTRIBUTORY:
(can't read it) | PHYSICIAN:
Wm. M. Campbell M.D. |
| | BURIAL | All Burial Information:
Ashland Cemetery (Dec 13, 1916)
|
|
BACK TO DEATH RECORDS PAGE
LAST RECORD | NEXT RECORD
|