NAME OF DECEASED |
COLOR |
SEX |
AGE |
MARRIED OR SINGLE |
PLACE OF BIRTH |
OCCUPATION |
DATE OF DEATH |
PLACE OF DEATH |
CAUSE OF DEATH |
DURATION OF LAST ILLNESS |
PLACE AND DATE OF INTERMENT |
NAME OF FATHER |
NAME OF MOTHER |
RECORDED |
| Frederick, Leslie | W | M | 2 | S | Ellsworth | June 22, 1903 | Ellsworth, OA | Cholera Infantium | 5 days | Beallsville, June 23, 1903 | Newton | Maude | June 29, 1903 |
