DEATH CERTIFICATE: Eliza Hall; Beaver co., Utah

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State Board of Health File No.: 42
Stamped File No.: 0400042

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: Eliza Hall
Former or Usual Residence: 
Sex: female
Color: white
Date of Birth: 10 Feb 1855
Age: 49y 10m 24d
Single, Married, Widowed, Divorced: widowed
Birthplace: Utah
Name of Father, Birthplace: W. M. Shelton, England
Maiden Name of Mother, Birthplace: Harriett Johnson, England

Occupation: housewife
Informant: Andrew Bohn
Address: Joseph, Utah

Place of Burial: Beaver City
Date of Burial: 7 Dec 1904
Undertaker: Jos. Ash
Address: Beaver

Medical Certificate of Death
Date of Death: 4 Dec 1904
Time: 8:30 am
Chief cause: septic pneumonia
Where contracted: Beaver
Duration: 7 days
Contributory if any: pneumonia
Where contracted: Beaver
Duration: 17 days
Signed Doctor: I. E. Huffman, M.D.
Date: 5 Dec 1904
Address: Beaver