VITALS - Death Certificate of:  Lois Russell; Fillmore, Millard co., Utah

Transcribed by Stephen D. Robison (kinseeker @ hotmail.com)
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FHL Film # 2230661, State of Utah, Death Certificates, Millard County:
Certificate Number: 0400644
Death place: Fillmore
Name: Lois Russell
Usual residence: Fillmore
How long resident: All her life

PERSONAL AND STATISTICAL PARTICULARS
Sex: Female
Color: white
Birth date: Oct 13 1904
Age: 0 y 1 m 14 d
Marital status: --
Birth place: Fillmore, Utah
Father: Richard G. Russell
Father's birth place: England
Mother: Mary Gull
Mother's birth place: Fillmore, Utah
Occupation: --
Informant: R. G. Russell
Informant's address: Fillmore, Utah
Burial place: Fillmore
Burial date: Nov 28
Undertaker: Joseph Seguine
Undertaker's address: Fillmore Utah
Filed:
Registrar:

MEDICAL CERTIFICATE OF DEATH
Death date: Nov 27 1904
Cause: Pneumonia
Where contracted: Fillmore
Duration: 10 days
Contributory: --
Where contracted: --
Duration: --
Doctor: J. C. Robison
Dated: Nov 28 1904

Permission is hereby granted to bury/ship the body of the person above described
Health Officer: J. C. Robison M.D.
Address: Fillmore
Date: Nov 28 1904