REGISTRATION OF DEATHS--NEILLSVILLE CLARK CO., VOL 1, 1870-1879

Pg. 35 #2

1. Full name of deceased: Borden, Lillian
2. Color: White
3. Sex: Female
4. Age: 2 yr., 11 mo., 22 da
5. Name of the father of deceased: Ebenezer Borden
6. Name of the mother of deceased: Catherine Borden
7. Occupation: Farmer
8. Place of Birth: Loyal, WI
9. Name of wife of deceased:
10. Name of husband of deceased:
11. Date of birth and date of death: Dec 13, 1877 - Dec 6, 1880
12. Cause of death: Whooping cough
13. Name of the place,
town or township, and county,
in which the person died: Loyal, Clark, WI
14. Name and location of burial ground
in which interred: Loyal burial ground
15. Name of person returning certificate: L. R. Beach, M.D.
16. Residence of such person: Loyal, WI
17. Date of certificate: Jan. 11 1880
18. Date of Registration: Jan. 19, 1880

Transcribed by Janet.