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RECORD OF INTERMENTS
- Date of Death
Age SES Social CAUSE OF DEATH Date of Interment Place of Interment
Dan LAST N&i1DFFCF.
State Year Month Day Per
years 'Natth. Year Month � Day Section Lot
;1d to
/97/ '7 .,90 7� 9Pw/1
13 o� .�
'3 /q �y 19 iy m 7 l /a/ ' �3
7 lipl '1/ e e� I '
a
7_I �'y /97
m'�C30 .yi��/
1v /97r q �,� iY 7! -v 721C7 op,
/ r�
If V2
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CITY OF CALDWELL, IDAHO
NAME OF UNDERTAKER
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122 .9'
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NEAREST RELATIVE OR FRIEND