Transcription
PLACE OF DEATH
County of Pulaski
Township of Tippecanoe
Town of Monterey
Indiana State Board of Health
CERTIFICATE OF DEATH.
Record Number
88
Full Name Henry Sinnamon
PERSONAL AND STATISTICAL PARTICULARS
Sex Male Color White
Single, Married,
Widowed or Divorced
Name of Husband
or Wife,
Date of Birth 4 (Month) 5 (Day) 1861 (Year)
Age 41 years, 1 months, 27 days.
Occupation Farmer
Birthplace Stark Co Ohio
Place of Death near Monterey
Name of Father George Sinnamon
Birthplace of Father Ireland
Name of Mother Isabella Stewart
Birthplace of Mother Ireland
The above stated personal particulars are true
to the best of my knowledge and belief.
INFORMANT
Emma Sinnamon
his wife
(Address) Monterey
MEDICAL CERTIFICATE OF DEATH
Date of Death 6 (Month) 2 (Day) 1902 (Year)
I HEREBY CERTIFY, That I attended deceased from
March 20th 1902, to May 31 1902
that I last saw h alive on May 31 1902, and that
death occurred on the date stated above, at 4 o'clock PM.
To the best of my knowledge and belief the cause of death was as follows:
Chief Cause Pulmonary Tuberculosis
Duration 6 months
Immediate Cause Pulmonary
Tuberculosis Duration 6 month
(Signed) Wm Kelsey M. D.,
6/3 1902 (Address) Monterey
Place of Burial or Removal
Galveston
Undertaker
P. H. Wagoner
Filed 6/2 1902
Wm Kelsey (Death Officer of County)
(Address) Monterey
Proposed date of Burial
June 5th
Address
Monterey
Indiana, Marriages, 1810-2001