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
Bollinger C 753 75

Date of Report
(Month/Day/Year)
  1. Name
  2. Sex and Color
  1. Age (Year/Month/Day)
  2. Occupation
Mar 31 1884
  1. John Belchamber
  2. Sex - Male
    Color - White
  1. 21 yrs
  2. railroader

Date of Death
(Month/Day/Year AM or PM)
Single, Married,
Widower or Widow
  1. Nationality
  2. Where Born
Jan 22 1884 11am Single
  1. American
  2. Bollinger 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
21 y
  1. Glen Allen
  2. Consumption
  1. 2 years

  1. Place of Burial
  2. Date of Burial
  1. Name of Undertaker
  2. Place of Business
Name and Residence
of Physician
Returning Certificate
  1. Glen Allen
  2. Mar 21 1884
  1. W.G. Waldo
  2. Lutesville MO
W.H. Pittman MD Lutesville 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.