DEATH CERTIFICATE: Willam James; Beaver co., Utah

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State Board of Health File No.: 11
Stamped File No.: 0400011

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

Full name of Deceased: William James
Former or Usual Residence: Frisco
Sex: Male
Color: white
Date of Birth: 24 Jun 1842
Age: 61y 9m 21d
Single, Married, Widowed, Divorced: married
Birthplace: Wales
Name of Father, Birthplace: don't know, Wales
Maiden Name of Mother, Birthplace: don't know, Wales

Occupation: miner, smelter man
Informant: David James
Address: Frisco

Place of Burial: Salt Lake City
Date of Burial: 
Undertaker: 
Address: 

Medical Certificate of Death
Date of Death: 14 Apr 1904
Time: 1 pm
Chief cause: carbolic acid
Where contracted: Frisco
Duration: 3 hours
Contributory if any: paralysis (general)
Where contracted: Frisco
Duration: 3 years
Signed Doctor: W. W. Cook, County Physician
Date: 14 Apr 1904
Address: Milford