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Death Certificate of Lucy Pratt Nebeker
Nov. 22, 1916
(click to enlarge)
State of Utah—Death Certificate
1. Place of Death
County: Utah
City: Pl. Grove
2. Full Name: Lucy Pratt Nebeker
Personal and Statistical Particulars
3. Sex: F
4. Color or Race: W
5. Single, Married, Widowed, or Divorced: Widow
6. Date of Birth: Sept. 15, 1847
7. Age: 69 yrs. 2 mos. 7 ds.
8. Occupation:
9. Birthplace: Nebraska
10. Name of Father: Orson Pratt
11. Birthplace of Father: New York
12. Maiden Name of Mother: Adelia A. Bishop
13. Birthplace of Mother: not known
14. Informant: Amy N. Slack
15. Filed: Nov. 25, 1916
Medical Certificate of Death
16. Date of Death: Nov. 22, 1916
17. I Hereby Certify, That I attended deceased from Nov. 17, 1916, to Nov. 22, 1916, that I last saw her alive on Nov. 21, 1916, and that death occurred, on the date stated above, at 5 p.m.
The cause of death was as follows:
Acute dilatation of heart
Contributory: Chronic nephritis
Duration: several yrs.
Signed: Hervy W. Vance, M.D.
Nov. 22, 1916 Address: Pleasant Grove
18. Length of Residence:
19. Place of Burial or Removal: Pleasant Grove
Date of Burial: Nov. 25, 1916
20. Undertaker: E.D. Olpin & son
Address: Pl. Grove
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