VITAL - Death: Bertha Mary Brownson; Brigham, Box Elder co., Utah

Transcribed & submitted by W. D. Samuelsen
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State Board of Health File No.: 65
Stamped File No.: 09400133

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

Full Name of Deceased: Bertha Mary Brownson
Former or Usual Residence: 
How long resident at place of death: 
Length of residence in the city: 
Length of residence in the state: 

Sex: female
Color: 
Date of Birth: 2 Apr 1887
Age: 17y7m18d
Single, Married, Widowed or Divorced: 
Name of Spouse: 
Birthplace: 
Name & Birthplace of Father: 
Maiden Name & Birthplace of Mother: 
Occupation: 
Type of occupation: 
Date last worked: 
Total time (years) in this occupation: 
Informant & Address: W. W. Brownson, Brigham
Place of Burial: Ogden
Date of Burial: 21 Nov 1904
Undertaker & Address: Elias Jensen

Date of Death: 20 Nov 1904
Attended Date: 
Time of Death: 7:05 am
Chief Cause of Death: pneumonia
Where contracted: 
Duration: 
Contributory if any: 
Where Contracted: 
Duration: 
Autopsy: 
Signed: E. A. Rich
Date of Signature: 20 Nov 1904
Address: Brigham