JOHN M. SCOTT Death Cert.

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STATE OF MONTANA---Bureau of Vital Statistics---Standard Certificate of
Death
						
1. Place of death:	
County:	Silver Bow	Registered No.  
Township:		City:	Butte		No.  High Ore Mine  
Length of residence in city or town where death occurred: 
How long in US if of foreign birth:   
2. Full Name:		JOHN M. SCOTT
A: Residence:	155 W. Pacific Street
3. Sex:	Male
4. Color/Race:	White
5. Single, Married, Widowed, or Divorced:	Married
A.  If married, widowed, or divorced, HUSBAND of (or) WIFE of:	   Merle
Scott

6.  Date of Birth:	11/25/1906
7. Age:        Years:	48 	Months:	Days: 
8. Social Security Number:     516-07-7303 
9. Trade, profession, or particular kind of work done:	Foreman
10. Industry or business in which work was done:		Anaconda Co
11. Date deceased last worked at this occupation:
12. Total time (years) spent in this occupation:
13. BIRTHPLACE:	Minnesota
14. NAME OF FATHER: 	Ben Scott
15. BIRTHPLACE OF FATHER		
16. NAME OF MOTHER:	Nellie Dolan
17. BIRTHPLACE OF MOTHER:	
18. INFORMANT:	Wife-Mrs. Merle SCOTT
19. BURIAL, CREMATION OR REMOVAL:	Burial at Holy Cross Cemetery  
9/29/55 Butte	
Date:   9/29/55

UNDERTAKER:	Duggen Merrill		Mortuary, Butte, Montana
FILED:	9/30/55

20. DATE OF DEATH:		9/27/1955
21. I hereby certify that I attended deceased from      9/26/55    to 
9/26/55
The Principal cause of death and related causes of importance in order
of onset were as follows:
ASPHYXIATION-9/26/55 at 1:30 PM while at work he was over come by bad
air while exploring old drift

22. Was disease or injury in any way related to occupation of
deceased?     YES, happened at work.
23. Signed:   Dr. Emmet J. PAULSEN-coroner;  courthouse, Butte, MT  
9/27/55
W.F. Antonish, MD? (hard to read)  registrar