VITAL - Death: Charlotte Loretta Hoskins; Portage, Box Elder co., Utah

Transcribed & submitted by W. D. Samuelsen
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State Board of Health File No.: 21
Stamped File No.: 0400093

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

Full Name of Deceased: Charlotte Loretta Hoskins
Former or Usual Residence: Portage
How long resident at place of death: 
Length of residence in the city: 
Length of residence in the state: 

Sex: female
Color: white
Date of Birth: 29 Dec 1859
Age: 44y3m13d
Single, Married, Widowed or Divorced: married
Name of Spouse: 
Birthplace: Weber co. Utah
Name & Birthplace of Father: William Lish
Maiden Name & Birthplace of Mother: 
Occupation: 
Type of occupation: 
Date last worked: 
Total time (years) in this occupation: 
Informant & Address: 
Place of Burial: 
Date of Burial: 
Undertaker & Address: 

Date of Death: 11 Apr 1904
Attended Date: 
Time of Death: 
Chief Cause of Death: Rheumatism and childbirth
Where contracted: 
Duration: 
Contributory if any: 
Where Contracted: 
Duration: 
Autopsy: 
Signed: 
Date of Signature: 
Address: