Personal Information

Full Name
Figures, infant Male
Notable
Last Name
Figures
First Name
infant
Middle Name
Male
Suffix
Prefix
Maiden Name
Time lived in city
Address
3222 Clay
Occupation
Blank
Age at Death

Dates

Date of Birth
2/9/1917
Date of Death
2/16/1917

Locations

Hospital
Birthplace
Texas
Father's Birthplace
Texas
Mother's Birthplace
Texas

Burial

Death Certificate
Y
Cause of Death
Tetanus
Undertaker
Jackson & Fairchild
Plot#
Inscription

Family

Spouse's Name
Marital Status
Father's Name
Figures, Lewis
Mother's Name
Polk, Carrie