VITAL - Death: Helen R. Foley; Brigham, Box Elder co., Utah

Transcribed & submitted by W. D. Samuelsen
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State Board of Health File No.: 64
Stamped File No.: 0400129

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

Full Name of Deceased: Helen R. Foley
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: 13 Sep 1865
Age: 39y1m
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: Rev. A. G. Rankin, Brigham
Place of Burial: Greensburg, Indiana
Date of Burial: Oct 1904
Undertaker & Address: Elias Jensen, Brigham

Date of Death: 13 Oct 1904
Attended Date: 
Time of Death: 3 pm
Chief Cause of Death: pulmonary tuberculosis
Where contracted: 
Duration: 
Contributory if any: 
Where Contracted: 
Duration: 
Autopsy: 
Signed: Edward A. Rich
Date of Signature: 13 Oct 1904
Address: Brigham