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Name: Laney, Sarah J.
Missouri State Board of Health - Bureau of Vital Statistics - Certificate of Death
Registration District No: 181, File No: 587-B, Primary Registration District: 4107,
Place of Death: Christian County,   City of Republic
Sex: Female
Race: White
Date of Birth: January 4, 1877
Age: 40 yrs. 21 ds.
Place of Birth: Madison Co., Arkansas
Father Name: William D. Wall        - Father Place of Birth: Weir Co., Georgia
Mother Name: Mary L. Bomes       -Mother Place of Birth: Green Co., Missouri
Informant: W.D. Wall                        Address: Republic, Mo.
Date of Death: January 25, 1917
Cause of death: Belatinal Pneumonia
Dr. and Address: Fred H. Brown, Billings, Mo.
Burial location and date: Blodes Chapel, January 27, 1917
Undertaker and location: A.S. Wallace, Billings, Mo.
Filed: January 28, 1917
Registrar: Fred H. Brown
(Transcribed from copy of original death certificate by Linda Irvin)

 

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