Date of Report (Month/Day/Year) | - Name
- Sex
- Color
| - Age (Year/Month/Day)
- Occupation
|
2/4/1884 | - Richey, William P.
- male
- white
| - 60y
- laborer
|
- Place of Burial
- Date of Burial
| - Name of Undertaker
- Place of Business
| Name and Residence of Physician Returning Certificate |
- Benton Twp.,
- 1/24/1884
|
| A. Mullinix, M.D., Rosendale |