Date of Report (Month/Day/Year) | - Name
- Sex
- Color
| - Age (Year/Month/Day)
- Occupation
|
Dec 24 1883 | - Pennison, Anne
- Female
- White
| - 98y
- Farmer's Wife
|
How long Resident in the state. | - Place of Death
- Cause of Death
| - Complication
- Duration of Complication
- Duration of Disease
|
50y | - Palestine Twp Cooper Co Mo
- Inflammation of the Bowels
| - Stomach very much deranged
- 4 weeks
|
- Place of Burial
- Date of Burial
| - Name of Undertaker
- Place of Business
| Name and Residence of Physician Returning Certificate |
- Pleasant Hill Church Cooper Co Mo
- Dec 5 1883
| - W.W. Taliaferro
- Booneville Mo
| W.E. Evans MD Booneville Mo |