Death Certificate of William Bailey
Feb. 14, 1947

death certificate of william bailey
(click to enlarge)

State of Utah
Certificate of Death

1. Place of Death
a. County: Juab
b. City: Nephi
c. Name of hospital or institution:
d. Length of stay: In this community: 83 years

2. Usual Residence of Deceased
a. State: Utah
b. County: Juab
c. City: Nephi

3. a. Full Name: William Bailey

4. Sex: Male

5. Color or race: White

6. a. Single, widowed, married, or divorced: Married
6. b. Name of husband or wife: Chloe Bailey
6. c. Age of wife if alive: 60 yrs.

7. Birth date of deceased: Jan. 29, 1864

8. Age: 83 Years, 0 Months, 15 Days

9. Birthplace: Nephi, Utah

10. Usual occupation: Farmer & Merchant
11. Industry or business:

12. Father Name: Langley A. Bailey
13. Father Birthplace: Whitwick, Lestershire, Eng.
14. Mother Maiden Name: Sarah Andrews
15. Mother Birthplace: Packington, Lestershire, Eng.

16. a. Informant’s own signature: H. Lee Bailey
b. Address: Nephi, Utah

17. a. Burial
b. Date thereof: 2-17-47
c. Place: burial or cremation: Nephi, Utah

18. a. Mortuary: Anderson Funeral Home
b. Signature of funeral directory: Miles G. Anderson
c. Address: Nephi   d. License No. 42
e.. Was body embalmed? Yes    f. Embalmer’s License No. 255

19. a. Date received: Feb-25-47

Medical Certification

20. Date of Death: 2-14-47

21. I Hereby Certify, That I attended deceased from Feb. 13, 1947, to Feb. 14, 1947; I last saw him alive on Feb. 14, 1947; death occurred on the date stated above, at 2 p.m.

Immediate cause of death:  Coronary occlusion
Duration: 12 hrs.

22. If death was due to external causes, fill in the following:

23. Signature: [See Image]
2-17-1947  Address: Nephi, Ut

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