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RECORD OF INTERMENTS
unn. nuuu,<us..u. �u.o u•us Date of Death
Age Social
--- PLACE OF BIRTH LAST RESIDENCE SEN State
Year Month DAYrs
Na of NANZ years Months I Dars
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CAUSE OF DEATH
CITY OF CALDWELL, IDAHO
Data of Interment Place of Interment
Permit LOCATION GRAVE FEE
year Month Day Section Lot
2,, log
p 7
M
4-7
011
NAME OF UNDERTAKER NEAREST RELATIVE OR FRIEND REMARKS