Death Certificate of Lucy Pratt Nebeker
Nov. 22, 1916

death certificate of lucy pratt nebeker
(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

Return to histories of Lucy Pratt