DEATH CERTIFICATE: David Cook Adams; Beaver co., Utah

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State Board of Health File No.: 
Stamped File No.: 0400004

Place of Death
County of: Beaver
City, Town or Village: Beaver
Street and No.: 
If in Hospital or Institution, give name: 

Full name of Deceased: David Cook Adams
Former or Usual Residence: Beaver City
Sex: Male
Color: White
Date of Birth: 24 Aug 1845
Age: 58 years 5 mos 16 days
Single, Married, Widowed, Divorced: married
Birthplace: Glendon Ironworks, Pennsylvania
Name of Father, Birthplace: David B. Adams, Scotland
Maiden Name of Mother, Birthplace: Mary Cook, Scotland

Occupation: farmer
Informant: J. S. Goodwin
Address: Beaver

Place of Burial: Beaver Mountain View
Date of Burial: 10 Feb 1904
Undertaker: Joseph Ash
Address: Beaver City

Medical Certificate of Death
Date of Death: 10 Feb 1904
Time: 
Chief cause: carcinona of rectum
Where contracted: Beaver County
Duration: 
Contributory if any: 
Where contracted: 
Duration: 
Signed Doctor: D. E. Huffman, M.D.
Date: 10 Feb 1904
Address: Beaver City