DEATH CERTIFICATE: Susannah Bonelli Bohn; Beaver co., Utah

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State Board of Health File No.: 28
Stamped File No.: 0400030

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: Susannah Bonelli Bohn
Former or Usual Residence: 
Sex: female
Color: white
Date of Birth: 66y 3m 13d
Age: 18 May 1838
Single, Married, Widowed, Divorced: widowed
Birthplace: Switzerland
Name of Father, Birthplace: John Bonelli, Switzerland
Maiden Name of Mother, Birthplace: don't know, Switzerland

Occupation: housewife
Informant: Lorenzo Bohn
Address: Beaver

Place of Burial: Beaver City
Date of Burial: 31 Aug 1904
Undertaker: Joseph Ash
Address: Beaver City

Medical Certificate of Death
Date of Death: 31 Aug 1904
Time: 4 am
Chief cause: pneumonia
Where contracted: Beaver
Duration: 3 days
Contributory if any: entercolitis
Where contracted: Beaver
Duration: 60 days
Signed Doctor: I. E. Huffman, M.D.
Date: 2 Sep 1904
Address: Beaver