Dept of Public Welfare Division of Public Health Form-------------
FORM H4 IOM
Department of Public Welfare---Division of Public Health
Office of the Loral Registrar Vital Statiatiea
MINNEAPOLIS, MINNESOTA
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12/26/1944
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CITY HALL
A C:tlfimte u Repaired by law
H.On Bee. Filed, Pern,ie•iov is Hereby Granted far the Pr r Disposition of the Remain, of,
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NAME
Baby Hoy Hillier SEX Male AGE 7days
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PLACE OF DEATH
Eitel Hospital IF VETERAN, NAME WAR
DATE OF DEATH
12/23/1944 NATIVITY Hpls., Mif8C ST Sinrle
CAUSE OF DEATH
Prematurity
MED. ATTENDANT
G. Te Schimelpfenig
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DISPOSITION
Chanhassen Cem. DATE 12/26/1944
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FUNERAL DIR.
Chanhassen Twsp., Mi 1396. ADDRESS
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PERMIT
Bardwell Funeral Service `/' , i! lL��,g,•y Minn.
NO.
1970
OF MEALTH ..d LOCAL REGISTRAR
COM.1..1ONER