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Death Records For:

 

1. Rosa E. Jacobs Williams - daughter of Sarah Jane Pair Jacobs

 

1.

 

1. Place of Death:  Flat River, St. Francois, Missouri
Reg. Dist. #  774, File #  15669, Primary Reg. Dist. #  4465, Registered # 45

2. Full Name:  Rosa E. [Jacobs] Williams

3. Sex:  F

4. Color or Race:  W

5.  Married

6.  Date of Birth:  Oct 4, 1883

7.  Age:  32 yrs  6 mo  13 da

8.  Occupation:  housewife - house work

9.  Birthplace:  Mo

10. Name of Father:  B. F. Jacobs

11.  Birthplace of Father:  Mo

12.  Maiden Name of Mother:  Sarah Pair

13.  Birthplace of Mother:  Mo

14.  Informant:  Walter Williams, Flat River, Mo.

15.  Filed:  April 18, 1916  Dr. Topping

16.  April 17, 1916

17.  [Doctor] Attended:  April 1 - April 17, 1916

Last Saw Alive:  April 15, 1916

Cause of Death:  Tuberculosis of the lungs

Contributory:  Appendicular Abcess

Signed:  M. H. Topping,  April 18, 1916, Flat River

18.  Length of Residence:  [blank]

19.  Place of Burial:  Dor Run, Mo

Date of Burial:  April 19, 1916

20.  Undertaker:  H. Rinke, Flat River