Missouri Digital Heritage :: Collections :: Birth & Death Records Database :: Death Record Detail

Missouri Birth & Death Records Database

Permanent Record of Deaths

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County Roll Number Page Number
Andrew C 93 3 38

Date of Report
(Month/Day/Year)
  1. Name
  2. Sex and Color
  1. Age (Year/Month/Day)
  2. Occupation
Feb 2,1884
  1. blank
  2. Sex - Male
    Color - White
  1. 1/4 d
  2. Infant son of Farmer

Date of Death
(Month/Day/Year AM or PM)
Single, Married,
Widower or Widow
  1. Nationality
  2. Where Born
Jan 22,1884 8 AM Single
  1. American
  2. Clay Twp. Andrew Co,Mo

How long Resident in the state. 1. Place of Death
2. Cause of Death
1. Complication
2. Duration of Complication
3. Duration of Disease
1/4 d
  1. Clay Twp. Andrew Co,Mo
  2. Premature Birth from causes unknown for at age 7?? Mo
  1. blank
  2. blank
  3. blank

  1. Place of Burial
  2. Date of Burial
  1. Name of Undertaker
  2. Place of Business
Name and Residence
of Physician
Returning Certificate
  1. Fillmore Cemetery
  2. blank
  1. A.Hanners
  2. Fillmore,MO
C.W.Spicer MD - Fillmore,Mo

NOTE
 

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Due to possible errors or discrepancies in this abstract it is recommended that researchers request a print copy. To request a copy of this record, please print a copy of this page and mail it to the Missouri State Archives, PO Box 1747, 600 W. Main Street,  Jefferson City, MO  65101 with a check or money order for $1.00 made payable to the Missouri State Archives.  Please include a #10 business size, stamped, self-addressed envelope with each request.  Please submit one photocopy request at a time.