Cass C 22925 39 498
Date of Report
(Month/Day/Year) Name
Sex and Color
Age (Year/Month/Day)
Occupation
05/16/1888 Adams, Nancy
Sex - Female
Color - White
78 yr 0 mo 0 days
farmer's wife
Date of Death
(Month/Day/Year AM or PM) Single, Married,
Widower or Widow Nationality
Where Born
04/12/1888 pm widow American
Clark Co., Kentucky
How long Resident in the state. 1. Place of Death
2. Cause of Death 1. Complication
2. Duration of Complication
3. Duration of Disease
52 yrs Dolan Twp. Cass County, MO
Pneumonia
7 days
Place of Burial
Date of Burial
Name of Undertaker
Place of Business
Name and Residence
of Physician
Returning Certificate
Freeman Cem.
04/13/1888
Colmer
Freeman, MO
Goforth, Freeman, MO
Date of Report
(Month/Day/Year) Name
Sex and Color
Age (Year/Month/Day)
Occupation
05/16/1888 Adams, Nancy
Sex - Female
Color - White
78 yr 0 mo 0 days
farmer's wife
Date of Death
(Month/Day/Year AM or PM) Single, Married,
Widower or Widow Nationality
Where Born
04/12/1888 pm widow American
Clark Co., Kentucky
How long Resident in the state. 1. Place of Death
2. Cause of Death 1. Complication
2. Duration of Complication
3. Duration of Disease
52 yrs Dolan Twp. Cass County, MO
Pneumonia
7 days
Place of Burial
Date of Burial
Name of Undertaker
Place of Business
Name and Residence
of Physician
Returning Certificate
Freeman Cem.
04/13/1888
Colmer
Freeman, MO
Goforth, Freeman, MO
Cass C 22925 39 498
Date of Report
(Month/Day/Year) Name
Sex and Color
Age (Year/Month/Day)
Occupation
05/16/1888 Adams, Nancy
Sex - Female
Color - White
78 yr 0 mo 0 days
farmer's wife
Date of Death
(Month/Day/Year AM or PM) Single, Married,
Widower or Widow Nationality
Where Born
04/12/1888 pm widow American
Clark Co., Kentucky
How long Resident in the state. 1. Place of Death
2. Cause of Death 1. Complication
2. Duration of Complication
3. Duration of Disease
52 yrs Dolan Twp. Cass County, MO
Pneumonia
7 days
Place of Burial
Date of Burial
Name of Undertaker
Place of Business
Name and Residence
of Physician
Returning Certificate
Freeman Cem.
04/13/1888
Colmer
Freeman, MO
Goforth, Freeman, MO
Date of Report
(Month/Day/Year) Name
Sex and Color
Age (Year/Month/Day)
Occupation
05/16/1888 Adams, Nancy
Sex - Female
Color - White
78 yr 0 mo 0 days
farmer's wife
Date of Death
(Month/Day/Year AM or PM) Single, Married,
Widower or Widow Nationality
Where Born
04/12/1888 pm widow American
Clark Co., Kentucky
How long Resident in the state. 1. Place of Death
2. Cause of Death 1. Complication
2. Duration of Complication
3. Duration of Disease
52 yrs Dolan Twp. Cass County, MO
Pneumonia
7 days
Place of Burial
Date of Burial
Name of Undertaker
Place of Business
Name and Residence
of Physician
Returning Certificate
Freeman Cem.
04/13/1888
Colmer
Freeman, MO
Goforth, Freeman, MO
Family Members
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