VITAL - Death: James Ipsen; Mantua, Box Elder co., Utah

Transcribed & submitted by W. D. Samuelsen
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State Board of Health File No.: 42
Stamped File No.: 0400130

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

Full Name of Deceased: James Ipsen
Former or Usual Residence: Mantua
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: 16 Feb 1823
Age: 81y8m5d
Single, Married, Widowed or Divorced: married
Name of Spouse: 
Birthplace: Denmark
Name & Birthplace of Father: Jeppa Ipsen, Denmark
Maiden Name & Birthplace of Mother: 
Occupation: farmer
Type of occupation: 
Date last worked: 
Total time (years) in this occupation: 
Informant & Address: John P. Ipsen; Bennington, Idaho
Place of Burial: Mantua
Date of Burial: 25 Oct 1904
Undertaker & Address: Rasmus Andersen, Geneva

Date of Death: 21 Oct 1904
Attended Date: 
Time of Death: 9 am
Chief Cause of Death: old age
Where contracted: 
Duration: 
Contributory if any: 
Where Contracted: 
Duration: 
Autopsy: 
Signed: 
Date of Signature: 
Address: