DEATH CERTIFICATE: Fredrick Joseph; Beaver co., Utah

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State Board of Health File No.: 20
Stamped File No.: 0400021

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

Full name of Deceased: Fredrick Joseph
Former or Usual Residence: Adamsville
Sex: male
Color: caucasian
Date of Birth: 
Age: 1m 1d
Single, Married, Widowed, Divorced: single
Birthplace: Adamsville
Name of Father, Birthplace: J. T. Joseph, Ohio
Maiden Name of Mother, Birthplace: Anna Gunn, Adamsville

Occupation: 
Informant: I. H. Joseph
Address: Adamsville

Place of Burial: Beaver
Date of Burial: 27 Jun 1904
Undertaker: J. Ash
Address: Beaver City

Medical Certificate of Death
Date of Death: 27 Jun1 904
Time: 
Chief cause: congestion of liver
Where contracted: 
Duration: 
Contributory if any: 
Where contracted: 
Duration: 
Signed Doctor: no physician, two witnesses, Abe Heslington & Fred T. Gunn
Date: 
Address: