Death Certificate of Jane Elizabeth Pratt Kesler
Nov. 23, 1912

death certificate of jane elizabeth pratt kesler
(click to enlarge)

State of Utah—Death Certificate

1. Place of Death
County: Salt Lake Co.
City: Salt Lake
No. 278 So. 13 East; 5 Ward

2. Full Name: Jane Elizabeth Pratt Kesler

Personal and Statistical Particulars

3. Sex: Female

4. Color or Race: White

5. Single, Married, Widowed or Divorced: Widowed

6. Date of Birth: Oct. 22, 1835

7. Age: 77 yrs. 1 mos. 1 ds.

8. Occupation: Housewife

9. Birthplace: New York State

10. Name of Father: Anson Pratt
11. Birthplace of Father: New York State
12. Maiden Name of Mother: Sarah Barker
13. Birthplace of Mother: New York State

14. Informant: A. A. Kesler
Address: Salt Lake City

15. Filed: 11-25, 1912

Medical Certificate of Death

16. Date of Death: Nov. 23, 1912

17. I Hereby Certify, That I attended deceased from Nov. 23, 1912, to Nov. 23, 1912, that I last saw her alive on Nov. 23, 1912, and that death occurred, on the date stated above, at 6 a.m. 

The cause of death was as follows:

Fatty degeneration of the heart

Signed: Harrece Shepherd, M.D.
Nov. 23, 1912  Address: Beaver, Utah

18. Length of Residence

19. Place of Burial or Removal: City Cem.
Date of Burial: Nov. 27, 1912

20. Undertaker: Jos. Wm. Taylor
Address: Salt Lake City

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