DEATH CERTIFICATE: Emma Wilson; Beaver co., Utah

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State Board of Health File No.: 39
Stamped File No.: 0400007

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: Emma Wilson
Former or Usual Residence: 
Sex: Female
Color: White
Date of Birth: 6 Apr 1866
Age: 38y 3m 3d
Single, Married, Widowed, Divorced: 
Birthplace: 
Name of Father, Birthplace: 
Maiden Name of Mother, Birthplace: 

Occupation: 
Informant: 
Address: 

Place of Burial: Santiaga, Iowa
Date of Burial: Mar 1904
Undertaker: 
Address: 

Medical Certificate of Death
Date of Death: 9 Mar 1904
Time: 
Chief cause: heart failure
Where contracted: 
Duration: 
Contributory if any: 
Where contracted: 
Duration: 
Signed Doctor: I. E. Huffman, M.D.
Date: 9 Mar 1904
Address: Beaver

Transcribed from Deteriorating Original Document