Entry Fields
County
County
Township
City
Name
Residence
Sex
Color or Race
Marital Status
Spouse of ?
Date of Birth
Age in years
Age in months
Age in days
Occupation
Industry Employed in ?
Birthplace
Name of father
Birthplace of father
Maiden Name of Mother
Birthplace of mother
Informant
Informant address
Signature
Cause of death
Attending physician
Place of burial
Undertaker
