Transcription
Agency: State of Minnesota, Division of Vital StatisticsNo. in Registration Book: 2
Place of Death: Prior Lake Village, Scott County
Full Name of Deceased: Carolin Dahms
Sex: female
Color or Race: German
Marital Status: Widowed
Date of Birth: July 6, 1820
Age: 91 years, 11 mos., 20 days
Occupation: none
Birthplace: Germany
Name of Father: Durhmke
Birthplace of Father: Germany
Maiden Name of Mother: Don't know
Birthplace of Mother: Germany
Informant: F.J. Miller
Address of Informant: Prior Lake
Filing Date: June 26, 1912
Registrar: James Sim???????
Address of Registrar: Prior Lake
Date of Death: June 25, 1912
Cause of Death: Physiological ?&? ?Exhaustion?
MD: [illegible]
Place of burial or removal: [no entry]
Date of Burial: June 27, 1912
Undertaker: A. Hirshe?
Address of Undertaker: Shakopee
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