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Certificate of Death 1. Place of Death: 2. Usual Residence 3. Name of Deceased: Agnes U. Pratt 4. Date of Death: Month: 5 Day: 25 Year: 1949 5. Sex: Female 6. Color or Race: White 7. Married, Never Married, Widowed, Divorced: Widowed 8. Date of Birth: Mo. Nov. Day 4 Year 1870 9. Age: 79 10. Usual Occupation: Housewife 11. Birthplace: Tooele, Utah 12. Citizen of What Country? 13. Father’s Name: James U. Pratt Birthplace: Scotland 14. Mother’s Maiden Name: Elizabeth Jones Birthplace: England Husband’s or Wife’s Name: Mathoni Wood Pratt 15. Was Deceased ever in U.S. Armed Forces: 16. Social Security: No. 17. Informant: Hospital Records, Utah State Hospital 18. Cause of Death 20. Autopsy? No. 22. I Hereby Certify that I attended the deceased from 7-15, 1947 to 5-25, 1949. That I last saw the deceased alive on 5-23, 1949, and that death occurred at 5:25 a.m. from the causes and on the date stated above. 23. Signature 24. Burial, Cremation, Removal: Removal Date Rec’d by Local Reg.: 5-25-49 |
The Five Pratt Brothers DVD More than 1000 DVDs have been sold in the first month since its release! This 2 hour documentary is an excellent production about our heritage. Order your copies of "The Five Pratt Brothers" DVD today with this order form. If you have already donated, simply write that on your order form to receive the discounted price. Make sure you order enough for Christmas presents for your children and grandchildren! |
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