Name of Deceased

Sex:

Male/Female

Color:

White/Black

Age

Married, Single

or Widowed

Residence

Place of Birth

Date of Death

Cause of Death

Name of Physician

Remarks

Joseph E. Edwards M W 88y 2m 16d Widowed N. Warren Street Pennsylvania 10-31-1943 Starvation Self Imposed +c E. L. Klock  
Daniel H. Heist M W 81y 3m Married West Market Pennsylvania 11-5-1943 Cardiac Dilatation E. L. Klock