VITAL - Death: William Victor Bassett; Collinston, Box Elder co., Utah

Transcribed & submitted by W. D. Samuelsen
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State Board of Health File No.: 230
Stamped File No.: 0400098

Place of Death: 
Precinct of: 
City, Town or Village: Collinston
Street and No.: 

Full Name of Deceased: William Victor Bassett
Former or Usual Residence: Beaver Dam, Utah
How long resident at place of death: 
Length of residence in the city: 
Length of residence in the state: 

Sex: male
Color: white
Date of Birth: 2 Sep 1890
Age: 13y4m23d
Single, Married, Widowed or Divorced: single
Name of Spouse: 
Birthplace: Cache co., Utah
Name & Birthplace of Father: Lorin Elias Bassett Jr., Cache co.
Maiden Name & Birthplace of Mother: Nora Roe, Cache co.
Occupation: laborer
Type of occupation: 
Date last worked: 
Total time (years) in this occupation: 
Informant & Address: L. E. Bassett; Collinston
Place of Burial: Beaver Dam
Date of Burial: 21 May 1904
Undertaker & Address: Frank Durfey, Collinston

Date of Death: 9 May 1904
Attended Date: 
Time of Death: 4 pm
Chief Cause of Death: accidental drowning
Where contracted: Bear River
Duration: 
Contributory if any: 
Where Contracted: 
Duration: 
Autopsy: 
Signed: Wm. G. Friday, M.D.
Date of Signature: 14 Jun 1904
Address: Collinston