1 Place of Death

County:  Clark

Township:  Butler

Village: 

City: 

STATE OF WISCONSIN

Department of Health - Bureau of Vital Statistics

Original Certificate of Death

                                                Registered No:  1

2 FULL NAME:  Nathan Cecil Brown

Personal and Statistical Particulars

Medical Certificate of Death

3 Sex

Male

4 Color

White

5 S/M/W/D

16 Date of Death (M/D/Y)

Dec 15, 1924

6 Date of Birth (M/D/Y)

17 I HERBY CERTIFY, That I attended deceased from

Dec 2, 1924 to Dec 15, 1924

that I saw him     alive  on Dec 14, 1924

and that death occurred on the date above, at *:30 AM

The cause of death was as follows:

Abscessfo

Contributory:  Bronchitis

Signed:  B. A. Cole

Date: Dec 16, 1924  Thorp

7 Age (Yrs/Mos/Ds/Hrs/Min)

2/9/9

8 Occupation

9 Birthplace

Clark Co., Wis

10 Name of Father

James C. Brown

11 Birthplace of Father

Dane Co., Wis

18 Length of Residence (Hospitals, etc.)

12 Maiden Name of Mother

Etta Belle Belden

13 Birthplace of Mother

Duran (?), Pepin Co., Wis

14 The above is true to the best of my knowledge

Informant:  B. A. Cole, M. D.

Address:  Thorp

19 Place of burial or removal

Date

Dec 17, 1924

15  File date - Registrar

Dec 16, 1924    H. C. Conklin

20 Undertaker

H. Cumins by H.  C. Conklin

Address

Stanley