VITALS, Death Certificate: Mary Morris Payne; Fillmore, Millard co., Utah

Transcribed by Stephen D. Robison (kinseeker @ hotmail.com)
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Payne, Mary Morris

FHL Film # 2229075, State of Utah, Death Certificates, Millard County:

              Certificate Number:  0600845
              Death place:  Fillmore
              Name:  Mary Payne
              Usual residence:  Fillmore
              How long resident:  41 yrs.

              PERSONAL AND STATISTICAL PARTICULARS
              Sex:  Female
              Color:  White
              Birth date:  Aug 21 1841
              Age:  64 y 5 m 7 d
              Marital status:  Married
              Birth place:  Duckenfield Lancshire England
              Father:  Jame Morris
              Father's birth place:  England
              Mother:  Mary Butterworth
              Mother's birth place:  Bolton Lacshire England
              Occupation:  House wife
              Informant:  James Payne
              Informant's address:  Fillmore Millard Co Utah
              Burial place:  Fillmore
              Burial date:  Jan 30 1906
              Undertaker:  Jesse Milgate
              Undertaker's address:  Fillmore, Utah

              MEDICAL CERTIFICATE OF DEATH
              Death date:  Jan 28 1906
              Cause:  Ascetise Abel. & Pari Cyt. 
              Where contracted:  Years ago
              Duration:  -- days
              Contributory:  Heart liver and kidney trouble
              Where contracted:  Fillmore
              Duration:  -- days
              Doctor:  T. O. Duckworth
              Dated:   Jan 28 1906  Fillmore
              Filed:  Feb 4 1906
              Registrar:  J. C. Robison M.D.